Individual
DR. SHAHED NICOLAS BADIYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DEPT RADIATION ONCOLOGY, LL, SAINT LOUIS, MO 63110-1032
(314) 747-7236
(314) 747-9557
Mailing address
660 S EUCLID AVE, CB 8224, SAINT LOUIS, MO 63110-1010
(314) 747-7236
(314) 747-9557
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
2018004388
MO
2085R0001X
Radiation Oncology Physician
Primary
R5241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200060591
—
MO
Enumeration date
09/10/2009
Last updated
07/12/2023
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