Healthcare Provider Details
I. General information
NPI: 1114901154
Provider Name (Legal Business Name): SEAN M PFLAUMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 12/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1211 UNION AVE SUITE 300
MEMPHIS TN
38104-6638
US
IV. Provider business mailing address
1211 UNION AVE SUITE 300
MEMPHIS TN
38104-6638
US
V. Phone/Fax
- Phone: 901-725-7551
- Fax: 901-725-9721
- Phone: 901-725-7551
- Fax: 901-725-9721
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0101X |
| Taxonomy | Anatomic Pathology Physician |
| License Number | 035166 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: