Provider Demographics
NPI:1700205622
Name:BRANDT, WHITNEY STINA (MD)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:STINA
Last Name:BRANDT
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:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-7260
Mailing Address - Fax:888-272-2816
Practice Address - Street 1:4500 FOREST PARK AVE
Practice Address - Street 2:DIV SURG CT ADULT THORACIC, 5TH FL
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2114
Practice Address - Country:US
Practice Address - Phone:314-362-7260
Practice Address - Fax:888-272-2816
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023026214208G00000X
CTB65389787895208600000X
ILB653897878952086S0122X, 2086S0102X, 2086S0129X, 2086X0206X, 2086S0127X, 208G00000X, 204F00000X, 208600000X, 390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200098815Medicaid