BRIAN R. ODUM (NPI# 1285945402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285945402 |
| Entity Type | Individual |
| Full Name | BRIAN R. ODUM |
| Credential | D.O. |
| Practice Address |
615 S. New Ballas Rd St. Louis MO 63141 |
| Mailing Address |
660 Office Parkway St. Louis MO 63141-7103 |
| Practice Telephone | 3142516000 |
| Practice Fax Number | 5738844612 |
| Mailing Telephone | 3149913556 |
| Mailing Fax Number | 3149910691 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2017-02-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
2014001410 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
615 S. NEW BALLAS RD |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053359281 | Allison Grace Tuttle | Physician Assistant | 615 S. New Ballas Rd, Mercy Hospital St. Louis, St. Louis, MO 63141 | 2006-06-02 |
| 1912203118 | Matthew D Poeschl | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2011-02-04 |
| 1356583504 | Connie Jean Wildt | Dietitian, Registered | 615 S. New Ballas Rd, St. Louis, MO 63141-8221 | 2009-04-02 |
| 1114171915 | Ashima Agarwal | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2008-11-06 |
| 1528261146 | Inna Treskov | Student in an Organized Health Care Education/Training Program | 615 S. New Ballas Rd, Suite: 6006-b, St. Louis, MO 63141 | 2007-06-10 |
| 1154355261 | Julie E. Kunkel | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700430121 | Garland Michael Upchurch | Pathology | Washington University Som Department of Pathology, 660 S Euclid Avenue, Cb 8118, St. Louis, MO 63110-1010 | 2019-07-25 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1437539756 | Juan Kang | Pathology | 12939 Banyan Town Dr., St. Louis, MO 63146 | 2015-06-02 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1730526500 | Parker Callaway Wilson | Pathology | 660. S Euclid Ave Cb 8118, Department of Pathology, St. Louis, MO 63110-6311 | 2013-06-03 |
| 1760758536 | Roman L Patrick Jr. | Pathology | 13109 Fourposter Ct, St. Louis, MO 63146 | 2012-03-27 |
| 1255426748 | Aloo Tehmton Mistry | Pathology | 13446 Thornhill Drive, St. Louis, MO 63131-1626 | 2006-10-03 |
| 1780689448 | Pathology Associates, PC | Pathology | 10010 Kennerly Road, St. Louis, MO 63128-2106 | 2005-06-17 |
| 1912203118 | Matthew D Poeschl | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2011-02-04 |
| 1407166101 | Caitlin Gayle Andrews | Pathology | 660 South Euclid Ave, Campus Box 8118, St. Louis, MO 63110 | 2010-10-15 |
| Find all providers in ST. LOUIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.