MEDICARE: DR. SCOTT MICHAEL PFAHLER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	34009598	OH
2	207W00000X	Ophthalmology Physician	H0066089	MD
3	207W00000X	Ophthalmology Physician	0102202008	VA

General Provider Information

NPI Number	:	1093923385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT MICHAEL PFAHLER D.O.

Provider Business Mailing Address
First Line	:	301 W 1ST ST
Second Line	:	SUITE 300
City	:	DAYTON
State	:	OH
Zip	:	45402-3033
Country	:	US
Telephone Number	:	937-228-5015
Fax Number	:	937-228-5971

Provider Business Practice Location Address
First Line	:	301 W 1ST ST
Second Line	:	SUITE 300
City	:	DAYTON
State	:	OH
Zip	:	45402-3033
Country	:	US
Telephone Number	:	937-228-5015
Fax Number	:	937-228-5971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	02/21/2017

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