Provider Demographics
NPI:1508846569
Name:PEDRAZA, HECTOR MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:MANUEL
Last Name:PEDRAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2808 MCLAMB PL
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1600
Mailing Address - Country:US
Mailing Address - Phone:919-736-2157
Mailing Address - Fax:919-580-0424
Practice Address - Street 1:2808 MCLAMB PL
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1600
Practice Address - Country:US
Practice Address - Phone:919-736-2157
Practice Address - Fax:919-580-0424
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32414207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8966567Medicaid
NCC76517Medicare UPIN
NC8966567Medicaid