Individual
ANITA M PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 JARRETT WHITE RD, DEPARTMENT OF PEDIATRICS, MCHK-PE, TRIPLER ARMY MEDICAL CENTER, HI 96859
(808) 433-6407
(808) 433-4837
Mailing address
22 S KAINALU DR, KAILUA, HI 96734-2722
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD-16097
HI
2080P0205X
Pediatric Endocrinology Physician
Primary
MD-16097
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD-16097
MEDICAL LICENSE
HI
Enumeration date
03/23/2006
Last updated
10/04/2017
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