Jonathan Pederson, DO is a
Family Medicine physician based in Fort George G Meade Md, Maryland. Jonathan Pederson is licensed to practice in Hawaii (license number DOS 1119) and his current practice location is Usameddac 2480 Llewellyn Ave, Fort George G Meade Md, Maryland. He can be reached at his office (for appointments etc.) via phone at
(202) 685-3100.
NPI number for Jonathan Pederson is 1164446050 and his current mailing address is Usameddac 2480 Llewellyn Ave, Fort George G Meade Md, Maryland. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164446050.
Physician's Profile
| Full Name | Jonathan Pederson |
|---|
| Gender | Male |
|---|
| Speciality | Family Medicine |
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| Location | Usameddac 2480 Llewellyn Ave, Fort George G Meade Md, Maryland |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164446050
- Provider Enumeration Date: 07/26/2006
- Last Update Date: 12/12/2024
Medical Identifiers
Medical identifiers for Jonathan Pederson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1164446050 | NPI | - | NPPES |
| VAD000 | Other | HI | UPN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | DOS 1119 (Hawaii) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonathan Pederson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Jonathan Pederson, DO Usameddac 2480 Llewellyn Ave, Fort George G Meade Md, MD 20755 Ph: (202) 685-3100 | Jonathan Pederson, DO Usameddac 2480 Llewellyn Ave, Fort George G Meade Md, MD 20755 Ph: (202) 685-3100 |
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