Provider Demographics
NPI:1760832562
Name:PELLETIER, DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:PELLETIER
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 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-4439
Mailing Address - Fax:
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-4439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-47118207ZP0102X
IAR-10594207ZB0001X, 207ZC0500X, 207ZD0900X, 207ZF0201X, 207ZH0000X, 207ZI0100X, 207ZM0300X, 207ZN0500X, 207ZP0102X, 207ZP0104X, 207ZP0105X, 207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology