Prendergast, Edward J

Prendergast, Edward J is an sole proprietor health care provider with primary practice located at 535 S Shore Dr , Madison WI 53715-1703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Prendergast, Edward J can be contacted via phone (608) 255-3786.

Contact Information

Primary practice address
535 S Shore Dr Madison WI 53715-1703
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 19055-020 Wisconsin

Profile Details

NPI number 1013963321
LBN Legal business name Prendergast, Edward J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 26th, 2006
Last updated Feb 3rd, 2014 - about 10 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 1013963321 NPPES
Wisconsin Other 117 DEAN HEALTH INSURANCE
Wisconsin MEDICAID 30330000 DEAN HEALTH INSURANCE

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