Provider Demographics
NPI:1356398747
Name:PFLUM, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:PFLUM
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 1:4750 E GALBRAITH RD
Mailing Address - Street 2:STE. 210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6705
Mailing Address - Country:US
Mailing Address - Phone:513-686-4830
Mailing Address - Fax:513-686-4836
Practice Address - Street 1:4750 E GALBRAITH RD
Practice Address - Street 2:STE. 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6705
Practice Address - Country:US
Practice Address - Phone:513-686-4830
Practice Address - Fax:513-686-4836
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056048P207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64936289Medicaid
OH0739044Medicaid
IN100388370Medicaid
KY64936289Medicaid
OH4082973Medicare PIN