Individual
FRED EDWARD PFENNIGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
521 MARTIN LUTHER KING JR WAY, MS: 521-2-TFM, TACOMA, WA 98405-4238
(253) 403-2900
Mailing address
3702 NEW VISION DR, BLDG B, FORT WAYNE, IN 46845-1703
(253) 403-2900
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01079968
IN
207Q00000X
Family Medicine Physician
MD 60211363
WA
Other
Enumeration date
06/11/2010
Last updated
04/27/2018
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