Provider Demographics
NPI:1598482945
Name:PFLUEGER PLASTIC SURGERY LLC
Entity Type:Organization
Organization Name:PFLUEGER PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REID
Authorized Official - Middle Name:R
Authorized Official - Last Name:PFLUEGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:260-433-4991
Mailing Address - Street 1:1924 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-4620
Mailing Address - Country:US
Mailing Address - Phone:260-433-4991
Mailing Address - Fax:
Practice Address - Street 1:1924 FOREST AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-4620
Practice Address - Country:US
Practice Address - Phone:260-433-4991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty