Individual
DR. KENNETH ROY PENDERGRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 LAMB CIR, CHRISTIANSBURG, VA 24073-6344
(540) 731-2000
(540) 731-2659
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101042805
VA
207R00000X
Internal Medicine Physician
Primary
04-45914
KS
207R00000X
Internal Medicine Physician
2022-01804
NC
208M00000X
Hospitalist Physician
0101042805
VA
208M00000X
Hospitalist Physician
04-45914
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255304697
—
VA
05
—
6036732
—
VA
Enumeration date
02/08/2006
Last updated
02/24/2026
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