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Individual
NEAL J PRENDERGAST JR.
Active
Individual
NEAL J PRENDERGAST JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01069486A
IN
208800000X
Urology Physician
Primary
32911
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10805597
CAQH PROVIDER ID
—
05
—
201028550
—
IN
05
—
64329113
—
KY
01
—
P00314098
RAILROAD MEDICARE
KY
01
—
P00895260
RAILROAD MEDICARE
KY
Enumeration date
09/29/2005
Last updated
08/24/2016
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