Healthcare Provider Details

I. General information

NPI: 1437318557
Provider Name (Legal Business Name): DAVID M. FENIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 CHARTER DR STE 230
COLUMBIA MD
21044-3259
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 410-772-7000
  • Fax:
Mailing address:
  • Phone: 443-738-2872
  • Fax: 443-738-2713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberD0067641
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: