Provider Demographics
NPI:1184770703
Name:PFLIEGER, MATTHEW AARON (DO)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:AARON
Last Name:PFLIEGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HAUENSTEIN RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-8803
Mailing Address - Country:US
Mailing Address - Phone:260-204-0505
Mailing Address - Fax:
Practice Address - Street 1:225 HAUENSTEIN RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-8803
Practice Address - Country:US
Practice Address - Phone:260-204-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004809A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300000275Medicaid