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NPI Code Detail

MEDICARE: DR. JOHN R PENDER IV MD

MEDICARE: DR. JOHN R PENDER IV MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician200301157NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
213688OTHERNCBCBS NC

General Provider Information

NPI Number : 1730174152
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN R PENDER IV MD
Provider Business Mailing Address
First Line : PO BOX 35100
Second Line :
City : BILLINGS
State : MT
Zip : 59107-5100
Country : US
Telephone Number : 406-238-2500
Fax Number :
Provider Business Practice Location Address
First Line : 2800 10TH AVE N
Second Line :
City : BILLINGS
State : MT
Zip : 59101-0703
Country : US
Telephone Number : 406-238-5046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 02/10/2022

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