Edward J Prendergast
Hematology & Oncology
535 S Shore Dr
Madison
, Wisconsin 53715-1703
Edward J Prendergast
Hematology & Oncology
535 S Shore Dr
Madison
, Wisconsin 53715-1703
(608) 255-3786
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About
Features
Specialties
- Hematology & Oncology
Languages spoken
- English
Location
First Address
- Edward J Prendergast
- 535 S Shore Dr
- Madison, WI
- Zip : 53715-1703
- Phone : (608) 255-3786
Second Address
- Edward J Prendergast
- 535 S Shore Dr
- Madison, WI
- Zip : 53715-1703
- Phone : (608) 255-3786
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RH0003X | Hematology & Oncology | 19055-020 | WI |
National Provider Identifier
| NPI | 1013963321 |
|---|---|
| Provider Name | Edward J Prendergast |
| First Address | Madison, WI 53715-1703 |
| Second Address | Madison, WI 53715-1703 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/05/2006 |
| Last Update Date | 03/02/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 117 | DEAN HEALTH INSURANCE (01) | WI |
| 30330000 | (05) | WI |
| B55838 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.