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KEVIN BRADLEY CEDERBERG MD NPI 1104020296


NPI Information

NPI: 1104020296
Provider Name: KEVIN BRADLEY CEDERBERG, MD
Classification: Radiology - 2085P0229X
Entity Type: Individual

Specialization: Pediatric Radiology

PECOS Registration: Yes

Address:
5323 HARRY HINES BLVD
DEPARTMENT OF RADIOLOGY
DALLAS, TX
ZIP 75390
Phone: (214) 648-8004
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Kevin Bradley Cederberg, MD is a pediatric radiology radiology in Dallas, TX with 20 years of experience. The provider is a radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. Kevin Bradley Cederberg, MD NPI is 1104020296. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2004

The provider's business location address is:

5323 HARRY HINES BLVD
DEPARTMENT OF RADIOLOGY
DALLAS, TX
ZIP 75390-896
Phone: (214) 648-8004

The NPI 1104020296 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/12/2007 and was last updated on 10/16/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyM6070TEXASNo
22085P0229XRadiologyPediatric RadiologyM6070TEXASYes
32085R0204XRadiologyVascular & Interventional RadiologyM6070TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1BP1-0018147OTHERINSTITUTIONAL PERMIT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.