Individual
JENNIFER R. PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4321 UNIVERSITY PKWY STE 101, EVANS, GA 30809
(706) 774-5995
(706) 774-5996
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7760
(706) 774-7766
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
052616
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000957932B
—
GA
05
—
G52616
—
SC
Enumeration date
10/02/2006
Last updated
10/17/2018
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