Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mitra B Boodram, MD

Individual provider Diagnostic Radiology Physician · NPI 1174537039

Dr. Mitra B Boodram, MD is a Diagnostic Radiology in Saint Louis, Missouri. Qualified in 1989, 37 years ago. Practices with Washington University, a 2,986-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
37
Licensed in
MO
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

11133 Dunn Rd Dept Radiology
Saint Louis, MO 63136-6163
Phone: (314) 362-7200
Fax: (314) 747-4189
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neuroradiology Physician (primary) Taxonomy 2085N0700X · Licence 110362 (MO)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 110362 (MO)

Record details

NPI number1174537039
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 28, 2006
Last updated in NPPESApril 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Washington University — 2986 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Saint Louis