Provider Demographics
NPI:1639128382
Name:PFUETZE, KARL D (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:D
Last Name:PFUETZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 430
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3722
Mailing Address - Country:US
Mailing Address - Phone:913-253-3000
Mailing Address - Fax:913-663-2980
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 430
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3722
Practice Address - Country:US
Practice Address - Phone:913-253-3000
Practice Address - Fax:913-663-2980
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0413791207RC0000X
MO2000165367207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201238029Medicaid
KS100093840BMedicaid
KS100093840BMedicaid
KSKA1701013Medicare PIN
KSC51126Medicare UPIN
MO45034940AMedicare ID - Type UnspecifiedMO MEDICARE #
KS45034940DMedicare ID - Type UnspecifiedKS MEDICARE #
MO201238029Medicaid