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Individual

GREGORY JOHN PRENDERGAST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-9000
Mailing address
5435 SIMPKINS CT, ELLICOTT CITY, MD 21043-6579
(847) 370-3716

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D0094757
MD
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/01/2019
Last updated
05/08/2023
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