Provider Demographics
NPI:1588641765
Name:BRINK, WHITNEY B (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:B
Last Name:BRINK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1212 PLEASANT ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1414
Mailing Address - Country:US
Mailing Address - Phone:515-243-8842
Mailing Address - Fax:515-282-9806
Practice Address - Street 1:1212 PLEASANT ST
Practice Address - Street 2:SUITE 405
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1414
Practice Address - Country:US
Practice Address - Phone:515-243-8842
Practice Address - Fax:515-282-9806
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA34043207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1241323Medicaid
IA0241323Medicaid
IA160053213OtherRR MEDICARE
IA1588641765Medicaid
IAH42539Medicare UPIN
IAI3315Medicare PIN