Provider Demographics
NPI:1124059209
Name:PFLUM, EUGENE WALTER (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:WALTER
Last Name:PFLUM
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 1:26 FOREST CIRCLE
Mailing Address - Street 2:BOX 3657
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-3657
Mailing Address - Country:US
Mailing Address - Phone:970-453-7066
Mailing Address - Fax:970-453-7066
Practice Address - Street 1:26 FOREST CIRCLE
Practice Address - Street 2:BOX 3657
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-3657
Practice Address - Country:US
Practice Address - Phone:970-453-7066
Practice Address - Fax:970-453-7066
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16536207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ776742Medicaid
NM000W7645Medicaid
CO01165364Medicaid
NM000W7645Medicaid
AZ776742Medicaid
TX8HBL51Medicare PIN