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Individual
DR. SCOTT D. PENDERGAST
Active
Individual
DR. SCOTT D. PENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35-07-2687-P
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
35-072687
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021869
—
OH
01
—
35-07-2687-P
OHIO LICENSE NUMBER
OH
Enumeration date
09/01/2005
Last updated
06/28/2021
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