IndividualActive
Mitra Boodram, MD
NPI 1174537039 · Neuroradiology Physician · Saint Louis, MO
Provider details
- NPI number
- 1174537039
- Entity type
- Individual
- Primary specialty
- Neuroradiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 110362 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
11133 Dunn Rd
Dept Radiology
Saint Louis, MO 63136-6163
Phone: (314) 362-7200
Fax: (314) 747-4189
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 7412011
Chicago, IL 60674-2011
Registry dates
- Enumerated
- 2006-07-28
- Last updated
- 2025-04-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.