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NPI Code Detail

MEDICARE: DR. KATHERINE MOSS PEDERSEN MD

MEDICARE:  DR. KATHERINE MOSS PEDERSEN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician01067517AIN

General Provider Information

NPI Number : 1336359280
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHERINE MOSS PEDERSEN MD
Provider Business Mailing Address
First Line : 51 N FORD RD
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-1233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 51 N FORD RD
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-1233
Country : US
Telephone Number : 317-973-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 08/09/2022

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Directions to “ DR. KATHERINE MOSS PEDERSEN MD” Practice Location

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