Individual
DANIEL ALEXANDER PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(919) 265-8143
Mailing address
PO BOX 146, UNION GROVE, NC 28689-0146
(919) 265-8143
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-07375
NC
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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