Provider Demographics
NPI:1699861740
Name:BISWAS, SAUMITRA (MD)
Entity type:Individual
Prefix:
First Name:SAUMITRA
Middle Name:
Last Name:BISWAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-269-4850
Mailing Address - Fax:417-269-4852
Practice Address - Street 1:3801 S. NATIONAL AVENUE
Practice Address - Street 2:7TH FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5210
Practice Address - Country:US
Practice Address - Phone:417-269-4850
Practice Address - Fax:417-269-4852
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001606172080P0203X
ARE-107362080N0001X
NY2959912080P0203X
VA01012335212080P0203X
WI476522080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine