Individual
SHANNON M PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1309 W 17TH ST, SIOUX FALLS, SD 57104-4663
(605) 328-8000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
104478
MN
207L00000X
Anesthesiology Physician
13968
ND
207L00000X
Anesthesiology Physician
49222
AZ
207L00000X
Anesthesiology Physician
52327
MN
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
Primary
12866
SD
390200000X
Student in an Organized Health Care Education/Training Program
RL10939
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
10/17/2008
Last updated
03/14/2022
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