Individual
DR. THOMAS ELLIOTT PENDERGRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 BLUE RIDGE RD STE 100, RALEIGH, NC 27612-8087
(919) 256-3576
Mailing address
5220 GREENS DAIRY RD, RALEIGH, NC 27616-4612
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101271086
VA
2085R0202X
Diagnostic Radiology Physician
Primary
2020-00123
NC
Other
Enumeration date
04/19/2014
Last updated
04/30/2023
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