Individual
DR. SIMON ST. JOHN PRENDIVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2015 RANDOLPH ROAD, SUITE 208, CHARLOTTE, NC 28207-1200
(704) 377-4009
Mailing address
13808 PROFESSIONAL CENTER DR, HUNTERSVILLE, NC 28078-7948
(704) 377-4009
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
200300278
NC
Other
Enumeration date
05/03/2006
Last updated
04/05/2022
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