Provider Demographics
NPI:1447223367
Name:MALNAR, GERARD J (MD)
Entity Type:Individual
Prefix:MR
First Name:GERARD
Middle Name:J
Last Name:MALNAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9806 W 125TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4743
Mailing Address - Country:US
Mailing Address - Phone:816-916-5392
Mailing Address - Fax:
Practice Address - Street 1:2 PROGRESS POINT PKWY
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2205
Practice Address - Country:US
Practice Address - Phone:636-916-9531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO114571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205883101Medicaid
MOE66445Medicare UPIN
MO263B965AMedicare ID - Type UnspecifiedMEDICARE NUMBER