Pedersen, Robert Alan

Pedersen, Robert Alan is an individual health care provider with primary practice located at 1505 Professional Ct , Dalton GA 30720-2500. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Pedersen, Robert Alan can be contacted via phone (706) 275-6121.

Contact Information

Primary practice address
1505 Professional Ct Dalton GA 30720-2500
Phone: (706) 275-6121
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 021783 Georgia

Profile Details

NPI number 1932179983
LBN Legal business name Pedersen, Robert Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jul 24th, 2008 - about 16 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 1932179983 NPPES
Georgia Other 406133349 MEDICARE RAILROAD
Georgia MEDICAID 000200307D MEDICARE RAILROAD

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