Healthcare Provider Details

I. General information

NPI: 1891798328
Provider Name (Legal Business Name): STEVEN F PFLUG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2005
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 JUDGE TANNER BLVD
COVINGTON LA
70433-7500
US

IV. Provider business mailing address

681 BOCAGE LN
MANDEVILLE LA
70471-1605
US

V. Phone/Fax

Practice location:
  • Phone: 985-867-4050
  • Fax: 985-867-4051
Mailing address:
  • Phone: 985-867-4050
  • Fax: 985-867-4051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number020652
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: