Individual
DR. JONATHAN PENDLETON
Active
Individual
DR. JONATHAN PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022201
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001222017
—
CT
05
—
004215324
—
CT
01
—
010022201CT01
BCBS & BCFP ID
CT
01
—
01022201
CIGNA
CT
01
—
060031
HEALTH NET
CT
01
—
110116250
RAIL ROAD MEDICARE ID
CT
01
—
1255448155
GHMC GROUP NPI ID
CT
01
—
135678
WELLCARE MEDICARE
CT
01
—
477354
AETNA
CT
01
—
5978401
CONNECTICARE
CT
01
—
P369805
OXFORD
CT
Enumeration date
08/12/2005
Last updated
07/09/2007
Update your record
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