Individual
DANIEL T PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 E RACINE ST, JANESVILLE, WI 53546-2343
(608) 371-8000
(608) 371-8942
Mailing address
3200 E RACINE ST, JANESVILLE, WI 53546-2343
(608) 371-8000
(608) 371-8942
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21306-020
WI
207RC0000X
Cardiovascular Disease Physician
Primary
21306-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1042
DEAN HEALTH INSURANCE
WI
05
—
30127100
—
WI
Enumeration date
06/15/2006
Last updated
11/30/2013
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