Pederson, Lee Carl
Pederson, Lee Carl is an individual health care provider with primary practice located at 1918 Randolph Rd Ste 300 , Charlotte NC 28207-1112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Pederson, Lee Carl can be contacted via phone (704) 333-0741.Contact Information
Primary practice address
1918 Randolph Rd Ste 300
Charlotte NC 28207-1112
Phone: (704) 333-0741
Fax: (704) 333-3356
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 200300515 | North Carolina |
Profile Details
| NPI number | 1083690622 |
|---|---|
| LBN Legal business name | Pederson, Lee Carl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2005 |
| Last updated | Nov 5th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083690622 | NPPES |
| North Carolina | MEDICAID | 891344 |
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