Provider Demographics
NPI:1225395346
Name:FLUGGA, ADAM WESLEY
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:WESLEY
Last Name:FLUGGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-2731
Mailing Address - Country:US
Mailing Address - Phone:419-306-5715
Mailing Address - Fax:
Practice Address - Street 1:631 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-2731
Practice Address - Country:US
Practice Address - Phone:419-306-5715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH20460Medicaid