Provider Demographics
NPI:1417940693
Name:PEDONE, AMY BETH (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:PEDONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16312 MOUNT AIRY RD
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1623
Mailing Address - Country:US
Mailing Address - Phone:717-227-3800
Mailing Address - Fax:
Practice Address - Street 1:16312 MOUNT AIRY RD
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1623
Practice Address - Country:US
Practice Address - Phone:717-227-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422702207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I10176Medicare UPIN