Provider Demographics
NPI:1295771061
Name:POHL, STEPHEN S (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:POHL
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 1:5 EXECUTIVE CIR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3345
Mailing Address - Country:US
Mailing Address - Phone:912-355-2400
Mailing Address - Fax:912-355-5324
Practice Address - Street 1:361 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3659
Practice Address - Country:US
Practice Address - Phone:912-355-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027107207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000468806CMedicaid
GA000468806DMedicaid
GA000468806JMedicaid
GAG27107Medicaid
GA000468806HMedicaid
GA10058861OtherAMERIGROUP
GA000468806DMedicaid
GA93BDGNLMedicare PIN
GA930018661Medicare PIN
GA93BDFRDMedicare PIN
GA93BDQSHMedicare PIN
GAD30487Medicare UPIN
GA000468806JMedicaid
GA930116784Medicare PIN
GA000468806HMedicaid