Individual
MICHAEL PFANNENSTIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
04-31930
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200386410C
—
KS
05
—
200386410E
—
KS
05
—
64095748
—
KY
05
—
97424374
—
CO
01
—
P00445745
RR MEDICARE
KS
Enumeration date
02/14/2006
Last updated
01/05/2012
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