Individual
DR. THEODIS ANTHONY MALTBIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1402 S GRAND BLVD # M260, SAINT LOUIS, MO 63104-1004
(314) 977-9851
(314) 977-9852
Mailing address
3244 HENRIETTA ST, SAINT LOUIS, MO 63104-1308
(217) 418-1679
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A186576
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2019
Last updated
08/25/2023
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