Individual
DR. AASTA RAE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(757) 314-7602
Mailing address
856 J CLYDE MORRIS BLVD, STE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5800
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101242243
VA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101242243
VA
Other
Enumeration date
09/11/2007
Last updated
08/04/2023
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