Provider Demographics
NPI:1821255647
Name:FLIGGE, PASTEL
Entity Type:Individual
Prefix:
First Name:PASTEL
Middle Name:
Last Name:FLIGGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-1558
Mailing Address - Country:US
Mailing Address - Phone:605-886-8471
Mailing Address - Fax:
Practice Address - Street 1:901 4TH ST NW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-1558
Practice Address - Country:US
Practice Address - Phone:605-886-8471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD8162207Q00000X
MN53561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine