Individual
DANA STUART PFAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2475 NORTH PARK STE 10, COLUMBUS, IN 47203-2215
(812) 376-9261
(812) 378-9518
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01029357A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000537534
ANTHEM PROVIDER NUMBER
—
05
—
100144870
—
IN
01
—
11485705
CAQH NUMBER
IN
Enumeration date
03/20/2006
Last updated
10/29/2020
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