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Dr. Mitra B Boodram, MD
Neuroradiology Physician in Saint Louis, Missouri
NPI 1174537039

Mitra B Boodram is a Neuroradiology Physician based in Saint Louis, MO and is specialized in Neuroradiology. Mitra B Boodram practices in Saint Louis, MO and has the professional credentials of MD. The NPI Number for Mitra B Boodram is 1174537039 and holds a License No. 110362 (Missouri).

The current practice location address for Mitra B Boodram is 11133 Dunn Rd, Saint Louis, MO and can be reached out via phone at 314-362-7200 and via fax at 314-747-4189.

Location: 11133 Dunn Rd, Saint Louis, MO, 63160-0352
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174537039
Provider Name
Mitra B Boodram
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
11133 Dunn Rd, Saint Louis, MO, 63160-0352
Phone Number
314-362-7200
Fax Number
314-747-4189
Provider Enumeration Date
07/28/2006
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
208285007 05 MO
institution
Provider Business Practice Location Address Details
Address
11133 Dunn Rd
City
Saint Louis
State
Missouri
Zip
63136-6163
Phone Number
314-362-7200
Fax Number
314-747-4189
person
Provider Business Mailing Address Details
Address
11133 Dunn Rd
City
Saint Louis
State
Missouri
Zip
63136-6163
Phone Number
314-362-7200
Fax Number
314-747-4189
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Neuroradiology
Taxonomy
2085N0700X
License No.
110362 (Missouri)
Definition
A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
110362 (Missouri)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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