Individual
DR. NISHANT PODDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15945 CLAYTON RD STE 120, BALLWIN, MO 63011-2490
(636) 256-5000
Mailing address
13125 BELLERIVE FARM DR, CREVE COEUR, MO 63141-6099
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
036147565
IL
207RX0202X
Medical Oncology Physician
036147565
IL
207RX0202X
Medical Oncology Physician
Primary
2012034335
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001507
—
MO
Enumeration date
05/03/2012
Last updated
05/09/2025
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