Mark Pederson is a Psychologist in Buffalo, Minnesota. Mark Pederson practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Mark Pederson is 1801994843. The last update date is 2007-07-08.
Mark Pederson's current location address is 102 Marty Dr, Buffalo, Minnesota. You can contact this provider via phone number 7636825420 and fax number 7636825803. The mailing address for Mark Pederson is 102 Marty Dr, Buffalo, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Pederson |
|---|---|
| Address | 102 Marty Dr, Buffalo, Minnesota |
| Phone Number | 7636825420 |
| Fax Number | 7636825803 |
| Sole Proprietor | N |
| Credentials | LP |
NPI Number Detail
| NPI Number | 1801994843 |
|---|---|
| Provider Enumeration Date | 2006-09-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 102 Marty Dr |
|---|---|
| City | Buffalo |
| State | Minnesota (MN) |
| Post Code | 55313 |
| Phone Number | 7636825420 |
| Fax Number | 7636825803 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | LP2544 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 110563 | MN | UCARE | |
| HP18919 | MN | HEALTHPARTNERS | |
| 62-20079 | MN | MEDICA | |
| 67D66PE | MN | BLUE CROSS BLUE SHIELD | |
| 1000260 | MN | PREFERRED ONE |
Post Comment/ Review Below
What is the unique identifier code issued to Mark Pederson by the Centers for Medicare & Medicaid Services (CMS)?
The Mark Pederson has been assigned the NPI (National Provider Identifier) 1801994843. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete address where Mark Pederson is physically located?
The Mark Pederson is situated at the following address: 102 Marty Dr, Buffalo, MN 55313.
What is the Mark Pederson's specialty and taxonomy code?
The Mark Pederson's specialty is Psychologist, and the corresponding taxonomy code is 103T00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1801994843 to Mark Pederson?
The Centers for Medicare & Medicaid Services originally issued the 1801994843 to Mark Pederson on 2006-09-21.
As of what date was the information regarding Mark Pederson, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mark Pederson, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
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