Individual
DR. FRED T. PULIDO JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1213 VIRGINIA ST E, THIRD FLOOR, CHARLESTON, WV 25301-2908
(304) 345-5466
(304) 345-5472
Mailing address
1213 VIRGINIA ST E, THIRD FLOOR, CHARLESTON, WV 25301-2908
(304) 345-5466
(304) 345-5472
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
10371
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114257000
—
WV
01
—
0359506
CIGNA
WV
01
—
225394
MAMSI
WV
01
—
3572755200
U.S. DEPT. OF LABOR
WV
Enumeration date
03/20/2006
Last updated
07/08/2007
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