Individual
DAHLIA A SAAD PENDERGRASS
Active
Individual
DAHLIA A SAAD PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
049137
CT
2084P0800X
Psychiatry Physician
Primary
049137
CT
2084P0800X
Psychiatry Physician
42062
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358640500
—
MN
01
—
P00003148
MEDICARE RAILROAD
MN
05
—
PENDING
—
CT
Enumeration date
12/07/2005
Last updated
10/22/2010
Update your record
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