| Warren J. Pendergast, M.d., Pllc | |
|
4700 Homewood Ct Ste 220 Raleigh NC 27609-5732 | |
| (919) 787-7125 | |
| (919) 781-9952 |
| Full Name | Warren J. Pendergast, M.d., Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4700 Homewood Ct Ste 220, Raleigh, North Carolina |
| Authorized Official Name and Position | Warren Josef Pendergast (OWNER) |
| Authorized Official Contact | 9197877125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren J. Pendergast, M.d., Pllc 4700 Homewood Ct Ste 220 Raleigh NC 27609-5732 Ph: (919) 787-7125 | Warren J. Pendergast, M.d., Pllc 4700 Homewood Ct Ste 220 Raleigh NC 27609-5732 Ph: (919) 787-7125 |
| NPI Number | 1881438364 |
|---|---|
| Provider Enumeration Date | 06/20/2024 |
| Last Update Date | 06/20/2024 |
| Certification Date | 06/20/2024 |
| Medicare PECOS PAC ID | 8123562030 |
|---|---|
| Medicare Enrollment ID | O20240702004583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881438364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Warren Josef Pendergast |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376549857 PECOS PAC ID: 7315219789 Enrollment ID: I20170818002467 |
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