Provider Demographics
NPI:1033118039
Name:WHITING, RICHARD B (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:B
Last Name:WHITING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12855 N 40 DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8666
Mailing Address - Country:US
Mailing Address - Phone:314-880-6100
Mailing Address - Fax:314-997-3248
Practice Address - Street 1:1027 BELLEVUE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1851
Practice Address - Country:US
Practice Address - Phone:314-645-6450
Practice Address - Fax:314-645-2560
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2020-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO30071207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200561157Medicaid
MO200561157Medicaid
P00002032Medicare PIN
MOA13690Medicare UPIN
MO041050166Medicare PIN