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
Phone: (207) 973-7000
Fax: (207) 973-5042
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1073566329 | NPPES |
Maine | MEDICAID | 332430099 |
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