Pedersen, Mark L

Pedersen, Mark L is an individual health care provider with primary practice located at 1948 1St Ave Ne , Cedar Rapids IA 52402-5321. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Pedersen, Mark L can be contacted via phone (319) 364-0121.

Contact Information

Primary practice address
1948 1St Ave Ne Cedar Rapids IA 52402-5321
Phone: (319) 364-0121
Fax: (319) 364-5684
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 27460 Iowa
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 27460 Iowa

Profile Details

NPI number 1801894282
LBN Legal business name Pedersen, Mark L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Aug 17th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801894282 NPPES
Iowa MEDICAID 2063628

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