Individual
DR. BRAD C WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12855 N 40 DR, SUITE 375, SAINT LOUIS, MO 63141-8635
(314) 567-6071
(314) 567-7961
Mailing address
12855 N 40 DR, SUITE 375, SAINT LOUIS, MO 63141-8635
(314) 567-6071
(314) 567-7961
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036-097383
IL
208800000X
Urology Physician
Primary
114377
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203832209
—
MO
Enumeration date
11/30/2005
Last updated
12/01/2021
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