Pedersen, Craig J

Pedersen, Craig J is an individual health care provider with primary practice located at 489 State St , Bangor ME 04401-6616. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Pedersen, Craig J can be contacted via phone (207) 973-7000.

Contact Information

Primary practice address
489 State St Bangor ME 04401-6616
Fax: (207) 973-5042
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-303 Maine

Profile Details

NPI number 1073566329
LBN Legal business name Pedersen, Craig J
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Dec 2nd, 2010 - about 14 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 1073566329 NPPES
Maine MEDICAID 332430099

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