Provider Demographics
NPI:1518061621
Name:PEDRO, JANET T (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:T
Last Name:PEDRO
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 1:505 WEST MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947
Mailing Address - Country:US
Mailing Address - Phone:302-856-2360
Mailing Address - Fax:
Practice Address - Street 1:505 W MARKET ST
Practice Address - Street 2:SUITE 140
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-2344
Practice Address - Country:US
Practice Address - Phone:302-856-2360
Practice Address - Fax:302-854-6798
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9824207RN0300X
DEC10008491207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124569804Medicaid
87E203OtherBLUE CROSS
TX124569804Medicaid
DE151786M11Medicare PIN