Individual
KENDALL A ITOKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6350 CLAYTON RD APT 101, SAINT LOUIS, MO 63117-2514
(314) 324-8658
Mailing address
6350 CLAYTON RD APT 101, SAINT LOUIS, MO 63117-2514
(314) 324-8658
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036091737
IL
208800000X
Urology Physician
Primary
100178
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113620031
MEDICARE
MO
Enumeration date
09/13/2006
Last updated
09/12/2023
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