Provider Demographics
NPI:1336237411
Name:PFALZ, HELMUT (MD)
Entity Type:Individual
Prefix:
First Name:HELMUT
Middle Name:
Last Name:PFALZ
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:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:MD
Mailing Address - Zip Code:20610-0054
Mailing Address - Country:US
Mailing Address - Phone:410-535-7530
Mailing Address - Fax:410-535-0642
Practice Address - Street 1:110 HOSPITAL RD
Practice Address - Street 2:SUITE 214
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678
Practice Address - Country:US
Practice Address - Phone:410-535-7530
Practice Address - Fax:410-535-0642
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059467208600000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400380200Medicaid
MD400380200Medicaid