Individual
DR. THOMAS JOSEPH PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, P-3-PULM, PORTLAND, OR 97239-1034
(503) 220-8262
(503) 721-7852
Mailing address
3710 SW US VETERANS HOSPITAL ROAD, P-3-PULM, PORTLAND VAMC, PORTLAND, OR 97239-1034
(503) 220-8262
(503) 721-7852
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
9551
NH
207RP1001X
Pulmonary Disease Physician
Primary
9551
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0RE3859
—
VT
05
—
80003859
—
NH
Enumeration date
08/01/2006
Last updated
03/02/2012
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