Individual
NIKITA WAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12380 DE PAUL DR, BRIDGETON, MO 63044-2511
(314) 447-9700
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(281) 724-3050
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2023033486
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200131311
—
MO
Enumeration date
06/28/2019
Last updated
12/02/2025
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