Provider Demographics
NPI:1568466282
Name:PFENDLER, DAVID FINK (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FINK
Last Name:PFENDLER
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 1:15410 NW BAKER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-8063
Mailing Address - Country:US
Mailing Address - Phone:503-472-4355
Mailing Address - Fax:
Practice Address - Street 1:15410 NW BAKER CREEK RD
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-8063
Practice Address - Country:US
Practice Address - Phone:503-472-4355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9514207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR152892Medicaid
ORC93528Medicare UPIN
OR0000BHGCPMedicare ID - Type Unspecified