Provider Demographics
NPI:1265486708
Name:STEFFLER, BRAD A (MD)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:A
Last Name:STEFFLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-470-5890
Mailing Address - Fax:251-471-7925
Practice Address - Street 1:2451 FILLINGIM ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2238
Practice Address - Country:US
Practice Address - Phone:251-470-5890
Practice Address - Fax:251-471-7925
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL87522085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009974240Medicaid
MS00124997Medicaid
AL51506266OtherBLUE CROSS
AL16-00402OtherUNITED HEALTH CARE
FL263325600Medicaid
AL009974210Medicaid
AL51515631OtherBLUE CROSS
AL009974240Medicaid
AL300127017Medicare ID - Type UnspecifiedRAILROAD PGBA
C76302Medicare UPIN