Provider Demographics
NPI:1700823705
Name:EILENDER, DAVID STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STUART
Last Name:EILENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HOSPITAL PL
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-6999
Mailing Address - Country:US
Mailing Address - Phone:907-714-4529
Mailing Address - Fax:907-714-4696
Practice Address - Street 1:240 HOSPITAL PL
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7559
Practice Address - Country:US
Practice Address - Phone:907-714-5611
Practice Address - Fax:907-714-4916
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301405809207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110B564040OtherBCR
AK214166Medicaid
MI4979198Medicaid
MI110B564040OtherBCR