Provider Demographics
NPI:1043255524
Name:PFLUEGER, ANGELIQUE (MD)
Entity Type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:
Last Name:PFLUEGER
Suffix:
Gender:F
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:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SHIPROCK
Mailing Address - State:NM
Mailing Address - Zip Code:87420-0160
Mailing Address - Country:US
Mailing Address - Phone:505-368-6401
Mailing Address - Fax:505-368-6431
Practice Address - Street 1:US HWY 491 NORTH
Practice Address - Street 2:
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420
Practice Address - Country:US
Practice Address - Phone:505-368-6401
Practice Address - Fax:505-368-6431
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS301892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS14704OtherPHS
AZ349617Medicaid
NM03959350Medicaid
KS104798OtherBCBS
KS12393859OtherMUTLIPLAN
KS201585OtherHPK
CO14189216Medicaid
KS200258240CMedicaid
KS239496OtherCOVENTRY
AZ349617Medicaid
KS12393859OtherMUTLIPLAN
NM03959350Medicaid
320059Medicare Oscar/Certification