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Individual

PETER G PRENDERGAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
207 OLD LEXINGTON RD, THOMASVILLE, NC 27360-3428
(336) 474-3444
(336) 474-8111
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 474-3444
(336) 474-8111

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
162805
NY
207R00000X
Internal Medicine Physician
Primary
2007-01027
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00418365
NY
05
5907559
NC
Enumeration date
05/03/2006
Last updated
02/21/2013
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