TIMOTHY LEE PENDERGRASS MD NPI 1588651020

NPI Information

  • NPI: 1588651020
  • Provider Name: TIMOTHY LEE PENDERGRASS, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 300 TUSKEGEE BLVD
    436 MDG CC STE 1B22
    DOVER AFB, DE
    ZIP 19902
  • Phone: (302) 677-2525

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NPI Details

Timothy Lee Pendergrass, MD is a diagnostic radiology radiology in Dover Afb, DE. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Timothy Lee Pendergrass, MD NPI is 1588651020. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

300 TUSKEGEE BLVD
436 MDG CC STE 1B22
DOVER AFB, DE
ZIP 19902-300
Phone: (302) 677-2525
Fax: (302) 677-2526

The enumeration date for this NPI number is 9/30/2005 and was last updated on 1/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology5757NORTH DAKOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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