Individual
WALTER L PENDERGRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2131 S 17TH ST, NHRMC ANESTHESIA DEPT., WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Mailing address
2131 S 17TH ST, NHRMC ANESTHESIA DEPT., WILMINGTON, NC 28401-7407
(910) 772-9202
(910) 772-9452
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
080616
NC
Other
Enumeration date
01/18/2007
Last updated
03/17/2021
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