Individual
DAVID J PENGILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 TACOMA AVENUE SOUTH, BISMARCK, ND 58504
(701) 323-6990
(701) 323-6994
Mailing address
PO BOX 5501, BISMARCK, ND 58506-5501
(701) 323-6000
(701) 323-5709
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6620
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17617
—
ND
Enumeration date
08/31/2006
Last updated
01/11/2011
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