Individual
TIMOTHY LEE PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 TUSKEGEE BLVD, 436 MDG CC STE 1B22, DOVER AFB, DE 19902-5300
(302) 677-2525
(302) 677-2526
Mailing address
300 TUSKEGEE BLVD, 436 MDG CC STE 1B22, DOVER AFB, DE 19902-5300
(302) 677-2525
(302) 677-2526
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5757
ND
Other
Enumeration date
09/30/2005
Last updated
01/22/2008
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