Individual
DR. ROBERT L. PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5881 W 16TH ST, GREELEY, CO 80634-2910
(970) 313-2700
(970) 313-2727
Mailing address
5881 W 16TH ST, GREELEY, CO 80634-2910
(970) 313-2700
(970) 313-2727
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
44175
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88007821
—
CO
01
—
P00944893
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
01/16/2006
Last updated
07/02/2013
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