Provider Demographics
NPI:1326363086
Name:FINGERHUT, DAVID ELLIOT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ELLIOT
Last Name:FINGERHUT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 KIMBROUGH RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2405
Mailing Address - Country:US
Mailing Address - Phone:901-767-4499
Mailing Address - Fax:901-767-5071
Practice Address - Street 1:1432 KIMBROUGH RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2405
Practice Address - Country:US
Practice Address - Phone:901-767-4499
Practice Address - Fax:901-767-5071
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51161207WX0107X, 390200000X, 207W00000X
MS23235207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006295Medicaid
AR204151001Medicaid
MS08836057Medicaid
TNQ006295Medicaid
NCNCT043AMedicare PIN
MS08836057Medicaid
TN103I186902Medicare PIN