Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 067429 | GA |
NPI | 1114987757 |
---|---|
Provider Name | Andrew L. Pendleton |
First Address | Savannah, GA 31404-6267 |
Second Address | Savannah, GA 31404-6220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003122073B | (05) | GA |
003122073C | (05) | GA |
GA1313 | (05) | SC |
P01059892 | RAILROAD MEDICARE (01) | GA |