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General NPI Number Information
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NPI Number | 1578986212
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Entity Type | Individual
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Provider Name | PANKAJ MATHUR MD
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Gender | Male
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1201 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1016
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Country | US
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Telephone | 314-257-2240
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Fax | 314-257-2241
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Provider Business Mailing Address
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Address Line | 4301 W MARKHAM ST # 810
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-686-8000
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E-8803
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2025006675
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2025006675
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License Number State | MO
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