Individual
DAYMON D PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 W MAIN ST, TUPELO, MS 38804-3917
(662) 432-4106
Mailing address
177 LEEK RD, MODESTO, CA 95357-0338
(209) 303-1664
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A173077
CA
207R00000X
Internal Medicine Physician
4301119035
MI
Other
Enumeration date
06/11/2017
Last updated
08/06/2021
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