Individual
OMAR MAATOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4129 N HIGHWAY 67, FLORISSANT, MO 63034-2825
(314) 355-6390
Mailing address
4129 N HIGHWAY 67, FLORISSANT, MO 63034-2825
(314) 355-6390
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2019039182
MO
208000000X
Pediatrics Physician
C10011752
DE
208D00000X
General Practice Physician
C10011752
DE
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Enumeration date
07/02/2013
Last updated
11/03/2020
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