MICHAEL PATRICK PRENDERGAST MD NPI 1730743964

NPI Information

NPI: 1730743964
Provider Name: MICHAEL PATRICK PRENDERGAST, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1 CHILDRENS PLZ
DAYTON, OH
ZIP 45404
Phone: (937) 641-3433
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Michael Patrick Prendergast, MD is a student in an organized health care education training program in Dayton, OH. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Michael Patrick Prendergast, MD NPI is 1730743964. 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:

1 CHILDRENS PLZ
DAYTON, OH
ZIP 45404-873
Phone: (937) 641-3433

The NPI 1730743964 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/23/2019 and was last updated on 9/25/2022.

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
1	208000000X	Pediatrics		MD26386	MAINE	No
2	390200000X	Student in an Organized Health Care Education/Training Program				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MD26386	OTHER	MAINE	MAINE BOARD OF MEDICINE

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: 4/28/2024

NPI Synchronization or Removal

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