Provider Demographics
NPI:1770506842
Name:PFEIFFER, PETER RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:RICHARD
Last Name:PFEIFFER
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 1:518 37TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2903
Mailing Address - Country:US
Mailing Address - Phone:360-922-2100
Mailing Address - Fax:360-938-0020
Practice Address - Street 1:518 37TH ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229
Practice Address - Country:US
Practice Address - Phone:360-922-2100
Practice Address - Fax:360-938-0020
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044482207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00234384OtherMEDICARE RR
WA2082950Medicaid
WA8427676Medicaid
WAP00234384OtherMEDICARE RR