Individual
DR. THOMAS PENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1421 N 7TH ST, TERRE HAUTE, IN 47807-1005
(812) 231-4608
(812) 231-4675
Mailing address
PO BOX 3036, INDIANAPOLIS, IN 46206-3036
(812) 231-4608
(812) 231-4675
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01039492
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
01039492A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100466090
—
IN
Enumeration date
08/29/2005
Last updated
09/25/2008
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