Individual
TAHIRA IMAN PRENDERGAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2522 WARM SPRINGS RD, COLUMBUS, GA 31904-5640
(706) 322-9313
Mailing address
2522 WARM SPRINGS RD, COLUMBUS, GA 31904-5640
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
75866
GA
Other
Enumeration date
07/03/2008
Last updated
09/27/2016
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