Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 33179 | MO |
NPI | 1023111028 |
---|---|
Provider Name | Dr. Nitai C Saha |
First Address | Saint Louis, MO 63122-5561 |
Second Address | Saint Louis, MO 63122-5561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20602 | BCBS (01) | MO |
33179 | MEDICAL LICENSE (01) | MO |
A26914 | (02) | MO |