Provider Demographics
NPI:1124108600
Name:PFEFFER, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:PFEFFER
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 1:1100 SUNSET LN
Mailing Address - Street 2:SUITE 1211A
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3378
Mailing Address - Country:US
Mailing Address - Phone:540-825-2900
Mailing Address - Fax:540-825-0644
Practice Address - Street 1:1100 SUNSET LN
Practice Address - Street 2:SUITE 1211A
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3378
Practice Address - Country:US
Practice Address - Phone:540-825-2900
Practice Address - Fax:540-825-0644
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046240208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7540582Medicaid
TX00B857U22Medicare PIN
VA340000448Medicare PIN
GA340005916Medicare PIN
VA340000447Medicare PIN
VAC89679Medicare UPIN