Pendse, Prabhakar Damodar

Pendse, Prabhakar Damodar is an sole proprietor health care provider with primary practice located at 2131 S 17Th St , Wilmington NC 28401-7407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Pendse, Prabhakar Damodar can be contacted via phone (910) 815-5830.

Contact Information

Primary practice address
2131 S 17Th St Wilmington NC 28401-7407
Phone: (910) 815-5830
Fax: (910) 815-5698
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 17733 North Carolina

Profile Details

NPI number 1588602122
LBN Legal business name Pendse, Prabhakar Damodar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 4th, 2006
Last updated Feb 7th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588602122 NPPES
North Carolina Other 4098357 AETNA
North Carolina MEDICAID 1588602122 AETNA
North Carolina Other 183728 AETNA
North Carolina MEDICAID 8966735 AETNA
North Carolina Other 66735 AETNA

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