Individual
DR. BLAKE EDWIN PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-6978
Mailing address
6034 MARDEL AVE, SAINT LOUIS, MO 63109-1350
(314) 832-9583
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2007001632
MO
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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