Individual provider · Type 1 NPI

Mitra B. Boodram, MD

Neuroradiology Physician · St. Louis, MO

NPI number 1174537039 Active

Practice location

11133 Dunn Rd, Dept Radiology
St. Louis, MO 63136-6163

Call (314) 362-7200 Map

Fax (314) 747-4189

Mailing address

PO Box 7412011
Chicago, IL 60674-2011

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician 2085R0202X110362 (MO)
Neuroradiology Physician Primary 2085N0700X110362 (MO)

Neuroradiology Physician: 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.

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About NPI 1174537039

Mitra B. Boodram, MD's National Provider Identifier is 1174537039, issued on Jul 28, 2006. The primary taxonomy on file is Neuroradiology Physician (2085N0700X), and the practice location is in St. Louis, MO. The record was last updated on Apr 15, 2025.