Provider Demographics
NPI:1437318557
Name:FENIG, DAVID M (MD)
Entity Type:Individual
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First Name:DAVID
Middle Name:M
Last Name:FENIG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:443-738-2872
Mailing Address - Fax:443-738-2713
Practice Address - Street 1:7625 MAPLE LAWN BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2565
Practice Address - Country:US
Practice Address - Phone:301-725-0134
Practice Address - Fax:301-725-0135
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2011-12-09
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Provider Licenses
StateLicense IDTaxonomies
MDD0067641208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD414881900Medicaid
MD731L/131440YZUMedicare PIN