Individual
DR. NISHA MANGALAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 268-4010
(314) 268-2775
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 268-4010
(314) 268-2775
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2008002908
MO
208000000X
Pediatrics Physician
2012012182
MO
2080P0206X
Pediatric Gastroenterology Physician
Primary
2012012182
MO
2080P0208X
Pediatric Infectious Diseases Physician
2012012182
MO
Other
Enumeration date
04/23/2008
Last updated
06/24/2025
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