Healthcare Provider Details
I. General information
NPI: 1265486708
Provider Name (Legal Business Name): BRAD A STEFFLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/20/2006
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2451 FILLINGIM ST
MOBILE AL
36617-2238
US
IV. Provider business mailing address
PO BOX 40480
MOBILE AL
36640-0480
US
V. Phone/Fax
- Phone: 251-470-5890
- Fax: 251-471-7925
- Phone: 251-470-5890
- Fax: 251-471-7925
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 8752 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: