Individual
AMAL F ANTOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1717 BIDDLE ST, SAINT LOUIS, MO 63106-3454
(314) 814-8531
(314) 814-8542
Mailing address
PO BOX 551, SAINT LOUIS, MO 63188-0551
(314) 814-8531
(314) 814-8542
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MO 36283
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201719820
—
MO
Enumeration date
07/03/2006
Last updated
05/10/2017
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