Individual
DANIEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 9TH ST SE, ROCHESTER, MN 55904-6756
(507) 288-3443
Mailing address
210 9TH ST SE, ROCHESTER, MN 55904-6756
(507) 288-3443
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
44050
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08-01109
MEDICA
MN
05
—
141091
—
MN
01
—
2159678
ARAZ
MN
01
—
444T5PE
BLUE CROSS
MN
05
—
44T5PE
—
MN
05
—
577577
—
IA
05
—
969670900
—
MN
01
—
9898
AVERA
MN
01
—
HP42865
HEALTHPARTNERS
MN
01
—
MH9041041407
PREFERREDONE
MN
Enumeration date
12/23/2005
Last updated
03/13/2015
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