Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bassam Malo, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1205148293

Bassam Malo, MD is a Neurology in Fenton, Missouri. Qualified in 2009, 17 years ago. Practices with SSM Medical Group Inc, a 560-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
17
Licensed in
MO
In the registry since
2010
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1055 Bowles Ave Ste 200
Fenton, MO 63026-2308
Phone: (636) 496-3900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1438 S Grand Blvd, Saint Louis, MO 63104-1027 — (314) 977-4828

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 2014020140 (MO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 2010019819 (MO)

Record details

NPI number1205148293
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 8, 2010
Last updated in NPPESNovember 16, 2020
Certification dateNovember 16, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROLOGY
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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