Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD-45543 | IA |
NPI | 1003867425 |
---|---|
Provider Name | Dr. Stephen Lansing Pedron |
First Address | Cedar Rapids, IA 52402-5062 |
Second Address | Cedar Rapids, IA 52402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 14/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD-45543 | IOWA MEDICAL LICENSE (01) | IA |