Provider Demographics
NPI:1679563639
Name:PFEFFER, ROBERT DAVID (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAVID
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 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:
Practice Address - Street 1:905 EAST HILL AVE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837
Practice Address - Country:US
Practice Address - Phone:509-662-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000267122085R0001X
MT66722085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3255PFOtherASURIS NW HEALTH
KZ561OtherBLUE CROSS OF IDAHO
000010150380OtherBLUE SHIELD OF IDAHO
7670662OtherAETNA
ID807071800Medicaid
WA0142238OtherLABOR & INDUSTRIES
WA8417248Medicaid
P00202524OtherRAILROAD MEDICARE
3255PFOtherASURIS NW HEALTH
E60616Medicare UPIN