Provider Demographics
NPI:1336199454
Name:PFEIFFER, FREDERICK E II (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:E
Last Name:PFEIFFER
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:274 IKERD DR SE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-3800
Mailing Address - Country:US
Mailing Address - Phone:704-517-5096
Mailing Address - Fax:
Practice Address - Street 1:103 COTTON CREEK RD
Practice Address - Street 2:
Practice Address - City:STAR
Practice Address - State:NC
Practice Address - Zip Code:27356-7954
Practice Address - Country:US
Practice Address - Phone:910-428-9020
Practice Address - Fax:910-428-9022
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC296412084N0400X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8967419Medicaid
NC8967419Medicaid
C85973Medicare UPIN