Pedersen, Walter Jm

Pedersen, Walter Jm is an sole proprietor health care provider with primary practice located at Sunny Isle Professional Building Suite 3-F, St. Croix VI 00820-4423. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Pedersen, Walter Jm can be contacted via phone (340) 778-6110.

Contact Information

Primary practice address
Sunny Isle Professional Building Suite 3-F St. Croix VI 00820-4423
Phone: (340) 778-6110
Fax: (340) 778-2919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 653 Virgin Islands

Profile Details

NPI number 1780671909
LBN Legal business name Pedersen, Walter Jm
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2005
Last updated Dec 11th, 2007 - about 19 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 1780671909 NPPES
Virgin Islands Other V1000011 TRICARE
Virgin Islands Other 1780671909 TRICARE
Virgin Islands Other 53699PE TRICARE
Virgin Islands Other 089045 TRICARE
Virgin Islands Other 0500138 TRICARE

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