Mitra B Boodram (NPI# 1174537039, PAC ID# 7911810924) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1174537039 |
| PAC ID by PECOS | 7911810924 |
| Professional Enrollment ID | I20080314000141 |
| Full Name | Mitra B Boodram |
| Organization Legal Name | MIDWEST RADIOLOGICAL ASSOCIATES PC |
| Address |
1101 W Liberty St Farmington MO 63640-1921 |
| Phone Number | 5737608075 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1989 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 4587624226 |
| Number of Group Practice Members | 42 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260180 | CHRISTIAN HOSPITAL NORTHEAST |
| 260009 | BOTHWELL REGIONAL HEALTH CENTER |
| 260113 | MISSOURI DELTA MEDICAL CENTER |
| 140002 | ALTON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1101 W Liberty St, Farmington, MO 63640-1921 | 5737608075 | MIDWEST RADIOLOGICAL ASSOCIATES PC |
| Organization Legal Name | MIDWEST RADIOLOGICAL ASSOCIATES PC |
| Physicians | 45 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monica Rae Drylewicz | Diagnostic Radiology | Midwest Radiological Associates PC | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 |
| Hilton I Price | Diagnostic Radiology | Midwest Radiological Associates PC | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 |
| Carrie C Morrison | Diagnostic Radiology | Midwest Radiological Associates PC | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 |
| John H Niemeyer | Diagnostic Radiology | Midwest Radiological Associates PC | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 |
| Gerald J Palagallo | Diagnostic Radiology | Midwest Radiological Associates PC | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 |
| Christopher O Thornton | Diagnostic Radiology | Midwest Radiological Associates PC | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 |
| Feraas Jabi | Diagnostic Radiology | Midwest Radiological Associates PC | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Toni C Roth | Diagnostic Radiology | Midwest Radiological Associates PC | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 |
| Kevin L Shady | Diagnostic Radiology | Midwest Radiological Associates PC | 1 Memorial Dr, Alton, IL 62002-6722 |
| Randall L Heller Iii | Diagnostic Radiology | Midwest Radiological Associates PC | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 |
| Street Address |
1101 W LIBERTY ST |
| City | FARMINGTON |
| State | MO |
| Zip | 63640-1921 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard C Dore | Certified Registered Nurse Anesthetist (crna) | Parkland Health Center | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Jamesy C Smith | Family Medicine | Physician Groups Lc | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Zahid Kaleem | Pathology | Mid-america Pathology Consultants, LLC | 1101 W Liberty St, Parkland Health Center, Farmington, MO 63640-1921 |
| Barbara Anderson | Certified Registered Nurse Anesthetist (crna) | Parkland Health Center | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Eric K Hale | Certified Registered Nurse Anesthetist (crna) | Parkland Health Center | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Megan D Huhman | Nurse Practitioner | Physician Groups Lc | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Feraas Jabi | Diagnostic Radiology | Midwest Radiological Associates PC | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Dwayne N Damba | Family Medicine | Southeastern Emergency Physicians of Memphis LLC | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Mohamed B Ramadan | Hospitalist | Physician Groups Lc | 1101 W Liberty St, Farmington, MO 63640-1921 |
| Matthew James Akers | Nurse Practitioner | Southeastern Emergency Services of Memphis PC | 1101 W Liberty St, Farmington, MO 63640-6119 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa R Long | Chiropractic | 307 E E Karsch Blvd, Farmington, MO 63640-1203 | |
| Abraham Ray Renaud | Chiropractic | Desired Health Chiropractic, LLC | 134 W Pine St, Farmington, MO 63640-1403 |
| Adam P Overcast | Chiropractic | Desired Health Chiropractic, LLC | 134 W Pine St, Farmington, MO 63640-1403 |
| Kathryn S Wiles | Physical Therapy | Aegis Group Practice LLC | 502 W Pine St, Farmington, MO 63640-1426 |
| Paula S Alvarez | Clinical Social Worker | Mineral Area Community Psychiatric Rehabilitation Center, Inc. | 560 W Pine St, Farmington, MO 63640-1426 |
| Christopher John Donze | Physical Therapy | Aegis Group Practice LLC | 502 W Pine St, Farmington, MO 63640-1426 |
| Bonnie L Hartrup | Clinical Social Worker | Mineral Area Community Psychiatric Rehabilitation Center, Inc. | 560 W Pine St, Farmington, MO 63640-1426 |
| Steven Wade | Qualified Audiologist | Sound Health Services PC | 501 W Pine St, Farmington, MO 63640-1439 |
| Gina L Heberlie | Nurse Practitioner | Midwest Health Group, LLC | 555 W Pine St, Farmington, MO 63640-1439 |
| Robin L Gipson | Clinical Social Worker | Hope and Healing Counseling Center LLC | 555 W Pine St, Farmington, MO 63640-1439 |
| Find all physicians in zip 63640 | |||
| City | FARMINGTON |
| Zip Code | 63640 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | FARMINGTON + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Mitra B Boodram.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.