Paul Pedersen in Bloomington - Internal Medicine
Paul Pedersen - NPI 1053403675
Paul Pedersen is a Internal Medicine in Bloomington, Illinois. Paul Pedersen practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Paul Pedersen is 1053403675. The last update date is 2020-10-05.
Paul Pedersen's current location address is 1701 E College Ave, Bloomington, Illinois. You can contact this provider via phone number 3096643120 and fax number 3096635742. The mailing address for Paul Pedersen is 1701 E College Ave, Bloomington, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Paul Pedersen |
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Address | 1701 E College Ave, Bloomington, Illinois |
Phone Number | 3096643120 |
Fax Number | 3096635742 |
Sole Proprietor | N |
Credentials | -- |
NPI Number Detail
NPI Number | 1053403675 |
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Provider Enumeration Date | 2006-09-29 |
Last Updated Date | 2020-10-05 |
Provider Mailing Address Detail
Address | 1701 E College Ave |
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City | Bloomington |
State | Illinois (IL) |
Post Code | 617042101 |
Phone Number | 3096643120 |
Fax Number | 3096635742 |
Provider's Primary Taxonomy Detail
Speciality | Internal Medicine |
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Taxonomy | 207R00000X |
Licence No | 036-059949 |
Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
36059949 | IL | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Paul Pedersen by the Centers for Medicare & Medicaid Services?
The Paul Pedersen has been issued the NPI (National Provider Identifier) 1053403675. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Paul Pedersen?
The Paul Pedersen is physically situated at 1701 E College Ave, in the city of Bloomington, state of IL, with the postal code 617042101.
What is the Paul Pedersen's area of specialization and corresponding taxonomy classification?
The Paul Pedersen's specialty field is Internal Medicine, and it falls under the taxonomy code 207R00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1053403675 to Paul Pedersen?
The Centers for Medicare & Medicaid Services assigned the 1053403675 to Paul Pedersen on 2006-09-29.
As of what date were the details related to Paul Pedersen most recently updated or revised?
The information pertaining to Paul Pedersen, including its address, specialty, and other relevant details, was last updated or revised on 2020-10-05.
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