Mallick, Meher S

Mallick, Meher S is an individual health care provider with primary practice located at 10004 Kennerly Rd Ste 361B , Saint Louis MO 63128-2141. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Mallick, Meher S can be contacted via phone (314) 843-3449.

Contact Information

Primary practice address
10004 Kennerly Rd Ste 361B Saint Louis MO 63128-2141
Phone: (314) 843-3449
Fax: (314) 843-8762
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 2001009904 Missouri
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 2001009904 Missouri

Profile Details

NPI number 1093789034
LBN Legal business name Mallick, Meher S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Mar 29th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093789034 NPPES
Illinois MEDICAID 036099093
Illinois Other 390007770
Illinois MEDICAID 6317901
Illinois Other 000013440

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