Provider Demographics
NPI:1649450214
Name:ARAUJO, PEDRO S (CRNA)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:S
Last Name:ARAUJO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 FOREST GROVE AVE
Mailing Address - Street 2:UNIT 3
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1096
Mailing Address - Country:US
Mailing Address - Phone:508-384-2989
Mailing Address - Fax:
Practice Address - Street 1:249 FOREST GROVE AVE
Practice Address - Street 2:UNIT 3
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1096
Practice Address - Country:US
Practice Address - Phone:508-384-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA232305367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000436701Medicare PIN