Provider Demographics
NPI:1093181166
Name:PFLAUM, EMILIJA F (PA)
Entity type:Individual
Prefix:
First Name:EMILIJA
Middle Name:F
Last Name:PFLAUM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:EMILIJA
Other - Middle Name:F
Other - Last Name:MCNULTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1084 INDUSTRIAL PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-3726
Mailing Address - Country:US
Mailing Address - Phone:251-675-5034
Mailing Address - Fax:251-679-8511
Practice Address - Street 1:1084 INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-3726
Practice Address - Country:US
Practice Address - Phone:251-675-5034
Practice Address - Fax:251-679-8511
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
511-66519OtherBCBS
511-66519OtherBCBS