Provider Demographics
NPI:1003867425
Name:PEDRON, STEPHEN LANSING (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LANSING
Last Name:PEDRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 A AVE NE STE 120
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5062
Mailing Address - Country:US
Mailing Address - Phone:319-297-9350
Mailing Address - Fax:319-297-9349
Practice Address - Street 1:855 A AVE NE STE 120
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402
Practice Address - Country:US
Practice Address - Phone:319-297-9350
Practice Address - Fax:319-297-9349
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-45543207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAMD-45543OtherIOWA MEDICAL LICENSE