| Doctor Name: | DR. ETHAN DOLF PFEFFERKORN |
| NPI Number: | 1891070785 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 13094-20 |
| Business Practice Address: | 15018 Lakeview Ln Three Lakes, WI - 545629518 |
| Business Phone Number: | 7154794482 |
| Business Fax Number: | |
| Mailing Address: | 15018 Lakeview Ln, THREE LAKES |
| State: | WI |
| Postal Code: | 545629518 |
| Phone Number: | 7154794482 |
| Fax Number: | |
| NPI Enumeration Date: | 10/11/2011 |
| NPI Last Update Date: | 10/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146D00000X |
| License Number: | 13094-20 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Personal Emergency Response Attendant |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals that are specially trained to assist patients living at home with urgent/emergent situations. These individuals must be able to perform CPR and basic first aid and have sufficient counseling skills to allay fears and assist in working through processes necessary to resolve the crisis. Functions may include transportation to various facilities and businesses, contacting agencies to initiate remediation service or providing reassurance. |