Individual
STEPHEN M PENDERGRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
4740 W MAIN ST, DOTHAN, AL 36305-9423
(334) 793-5000
Mailing address
95 MAREE DR, DALEVILLE, AL 36322-6228
(334) 477-1442
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-127254
AL
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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