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General NPI Number Information
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NPI Number | 1073192324
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Entity Type | Individual
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Provider Name | NISHA BHUPESH PATEL MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1110 HIGHLANDS PLAZA DR E STE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1353
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Country | US
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Telephone | 314-996-8670
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Fax |
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Provider Business Mailing Address
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Address Line | 660 S EUCLID AVE CAMPUS BOX 8122-0021-03
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1010
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Country | US
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Telephone | 314-454-7376
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 2025012240
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 31676
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 72019
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License Number State | MN
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