Frederick E Pfeiffer II, MD

Individual provider Active NPI Neurology Physician · Star, NC

NPI 1336199454 · NPPES record last updated May 13, 2015

Key facts

NPI
1336199454
Entity type
Individual (NPI type 1)
Primary specialty
Neurology Physician 2084N0400X
License
29641 (NC)
Practice address
103 Cotton Creek Rd
Star, NC 27356-7954
Phone
(910) 428-9020
Fax
(910) 428-9022
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29641NCMDNeurology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 29641 NC Yes
Internal Medicine Physician 207R00000X 29641 NC

Addresses

Primary practice location

103 Cotton Creek Rd
Star, NC 27356-7954

Mailing address

274 Ikerd Dr SE
Concord, NC 28025-3800
Phone (704) 517-5096

Other identifiers

IdentifierTypeStateIssuer
8967419MedicaidNC

Other providers in Star, NC

All providers in Star, NC · Neurology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.