Individual
HOLLY JANE PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9500 EUCLID AVE, A80, CLEVELAND, OH 44195-0001
(216) 444-3052
Mailing address
9500 EUCLID AVE, A80, CLEVELAND, OH 44195-0001
(216) 444-3052
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-067285
OH
208600000X
Surgery Physician
35067282
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112630
—
OH
Enumeration date
04/26/2007
Last updated
12/06/2011
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