Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brady Augustus Wahlstrom, MD

Individual provider Diagnostic Radiology Physician · NPI 1518752328

Brady Augustus Wahlstrom, MD is a Diagnostic Radiology Physician in Saint Louis, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2025
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone: (801) 528-2214
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 2025019940 (MO)

Record details

NPI number1518752328
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 11, 2025
Last updated in NPPESJune 9, 2025
Certification dateJune 9, 2025

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