Provider Demographics
NPI:1831480755
Name:PEDERSEN, WILLIAM ROBERT MUNK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ROBERT MUNK
Last Name:PEDERSEN
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 1:200 LOTHROP STREET
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-647-3500
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP STREET
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1521
Practice Address - Country:US
Practice Address - Phone:412-647-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4618982085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology