Individual
DR. DANIEL S PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2844 INDEX RD, FITCHBURG, WI 53713-3117
(608) 229-7979
(608) 229-8110
Mailing address
2844 INDEX RD, FITCHBURG, WI 53713-3117
(608) 229-7979
(608) 229-8110
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.073406
IL
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
77190-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578049763
—
WI
Enumeration date
07/11/2018
Last updated
08/03/2022
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