Individual
DANIEL LEE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4010 W 65TH ST, EDINA, MN 55435-1706
(952) 456-7000
(952) 456-7001
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10811
MN
363AS0400X
Surgical Physician Assistant
10811
MN
Other
Enumeration date
09/17/2010
Last updated
11/10/2022
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