Provider Demographics
NPI:1730972522
Name:FLUTH, CHAD MARTIN (OD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MARTIN
Last Name:FLUTH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 WINDMERE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7644
Mailing Address - Country:US
Mailing Address - Phone:814-234-2015
Mailing Address - Fax:
Practice Address - Street 1:428 WINDMERE DR STE 100
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7644
Practice Address - Country:US
Practice Address - Phone:814-234-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11414TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist