Provider Demographics
NPI:1861434342
Name:PICHLER, DONALD EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:EDWARD
Last Name:PICHLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 EUBANK BLVD NE
Mailing Address - Street 2:SUITE F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3575
Mailing Address - Country:US
Mailing Address - Phone:505-292-4080
Mailing Address - Fax:505-292-1839
Practice Address - Street 1:3825 EUBANK BLVD NE
Practice Address - Street 2:SUITE F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3575
Practice Address - Country:US
Practice Address - Phone:505-292-4080
Practice Address - Fax:505-292-1839
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM79-249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM201007791OtherPHP PROVIDER NUMBER
NM002400018OtherCIGNA PROVIDER NUMBER
NM2135OtherBCBS OF NM PROVIDER NUMBE
NM10900Medicaid
NM4469233OtherAETNA PROVIDER NUMBER
NM201007791OtherPHP PROVIDER NUMBER