Individual
MARK L PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1948 1ST AVE NE, CEDAR RAPIDS, IA 52402-5321
(319) 364-0121
(319) 364-5684
Mailing address
1948 1ST AVE NE, CEDAR RAPIDS, IA 52402-5321
(319) 364-0121
(319) 364-5684
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
27460
IA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
27460
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2063628
—
IA
Enumeration date
07/11/2005
Last updated
08/17/2011
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