Dr. Thomas Elliott Pendergrast, M.D.
Radiology, Diagnostic Radiology in Raleigh, NC. Individual provider (NPI-1).
NPI number1548680366
StatusActive
Last updated in NPPESApr 30, 2023
Details
- NPI
- 1548680366
- Entity type
- Individual (NPI-1)
- Name
- Dr. Thomas Elliott Pendergrast
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2014
- Certification date
- Apr 30, 2023
- Last updated
- Apr 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | 2020-00123 | NC | Yes |
| 2085R0202X | Radiology, Diagnostic Radiology | 0101271086 | VA |
Practice location
3200 Blue Ridge Rd Ste 100Raleigh, NC 27612-8087
Phone 919-256-3576
Mailing address
5220 Greens Dairy RdRaleigh, NC 27616-4612
Other practice locations
1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Lynchburg, VA 24501-1109
Phone 434-200-5047 · Fax 434-200-6490
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