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MARK L PRENDERGAST MD NPI 1255322681


NPI Information

NPI: 1255322681
Provider Name: MARK L PRENDERGAST, MD
Classification: Otolaryngology - 207Y00000X
Entity Type: Individual
Address:
707 BRYANT ST
STATESVILLE, NC
ZIP 28677
Phone: (704) 873-5224
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Mark L Prendergast, MD is an otolaryngology in Statesville, NC. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. Mark L Prendergast, MD NPI is 1255322681. 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:

707 BRYANT ST
STATESVILLE, NC
ZIP 28677-142
Phone: (704) 873-5224

The enumeration date for this NPI number is 11/3/2005 and was last updated on 1/25/2008.


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
1207Y00000XOtolaryngology31358NORTH CAROLINAYes

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
18966734MEDICAIDNORTH CAROLINA
2209702CMEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
3C86049MEDICARE UPINNORTH CAROLINA

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: 5/5/2024

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