Provider Demographics
NPI:1356470264
Name:PENDER, JENNIFER D (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:PENDER
Suffix:
Gender:F
Credentials:MD, MPH
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Other - Credentials:
Mailing Address - Street 1:1800 COLONIAL DR
Mailing Address - Street 2:WILLIAM S. HALL PSYCHIATRIC INSTITUTE ATTN: DR. PENDER
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6827
Mailing Address - Country:US
Mailing Address - Phone:803-898-1593
Mailing Address - Fax:803-898-1617
Practice Address - Street 1:1800 COLONIAL DR
Practice Address - Street 2:WILLIAM S. HALL PSYCHIATRIC INSTITUTE ATTN: DR. PENDER
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6827
Practice Address - Country:US
Practice Address - Phone:803-898-1593
Practice Address - Fax:803-898-1617
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC242872084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC242874Medicaid