Basic Information
| Provider Information | |||||||||
| NPI: | 1821255647 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLIGGE | ||||||||
| FirstName: | PASTEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 4TH ST NW | ||||||||
| Address2: | |||||||||
| City: | WATERTOWN | ||||||||
| State: | SD | ||||||||
| PostalCode: | 572011558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6058868471 | ||||||||
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| Practice Location | |||||||||
| Address1: | 901 4TH ST NW | ||||||||
| Address2: | |||||||||
| City: | WATERTOWN | ||||||||
| State: | SD | ||||||||
| PostalCode: | 572011558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6058868471 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2008 | ||||||||
| LastUpdateDate: | 08/31/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 8162 | SD | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 53561 | MN | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.