Provider Demographics
NPI:1396035176
Name:PEASE, DANIEL FELLOWS (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:FELLOWS
Last Name:PEASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVENUE
Mailing Address - Street 2:MAIL CODE G5
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415
Mailing Address - Country:US
Mailing Address - Phone:612-873-2705
Mailing Address - Fax:612-904-4366
Practice Address - Street 1:701 PARK AVENUE
Practice Address - Street 2:MAIL CODE G5
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415
Practice Address - Country:US
Practice Address - Phone:612-873-2705
Practice Address - Fax:612-904-4366
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN58434207RH0003X
MN107519207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine