Individual
DR. MARK L. PFAUTSCH
Active
Individual
DR. MARK L. PFAUTSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R8A13
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-077507
IL BLUE CROSS BLUE SHIELD
IL
01
—
063896
HEALTH ALLIANCE
—
05
—
143794001
—
AR
01
—
185214
185214
MO
01
—
187175
HEALTHLINK
—
05
—
242662005
—
MO
01
—
430954380CAP
MERCY HEALTH PLAN
—
Enumeration date
08/01/2006
Last updated
04/29/2021
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