Individual
DR. DANIEL GRANT PETEREIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 719-8559
(605) 719-2310
Mailing address
PO BOX 8010, 353 FAIRMONT BLVD, RAPID CITY, SD 57709-8010
(605) 719-8559
(605) 719-2310
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
31368
WI
2085R0001X
Radiation Oncology Physician
Primary
4542
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120275800
—
WY
05
—
6630570
—
SD
01
—
920005340
RAILROAD MEDICARE
—
Enumeration date
09/19/2005
Last updated
09/27/2012
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