Active NPI
Fred T. Pulido Jr., M.D.
- Plastic Surgery Physician
- Charleston, WV
National Provider Identifier
1114986031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 10371
- Practice address
- 1213 Virginia St E
Third Floor
Charleston, WV 25301-2908 - Phone
- (304) 345-5466
- Fax
- (304) 345-5472
- NPI assigned
- Mar 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 10371 | WV | Primary |
Addresses
Primary practice location
1213 Virginia St E
Third Floor
Charleston, WV 25301-2908
Mailing address
1213 Virginia St E
Third Floor
Charleston, WV 25301-2908
Phone (304) 345-5466
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0114257000 | Medicaid | WV | |
| 3572755200 | Other | WV | U.S. DEPT. OF LABOR |
| 0359506 | Other | WV | CIGNA |
| 225394 | Other | WV | MAMSI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1114986031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 VIRGINIA ST E",
"address_2": "THIRD FLOOR",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253012908",
"telephone_number": "304-345-5466",
"fax_number": "304-345-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 VIRGINIA ST E",
"address_2": "THIRD FLOOR",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253012908",
"telephone_number": "304-345-5466",
"fax_number": "304-345-5472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULIDO",
"first_name": "FRED",
"middle_name": "T.",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "WV",
"license": "10371",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0114257000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U.S. DEPT. OF LABOR",
"identifier": "3572755200",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0359506",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "225394",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.