Provider Demographics
NPI:1992827869
Name:PETERSON, DANIEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:PETERSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-778-4066
Mailing Address - Fax:615-778-9114
Practice Address - Street 1:5320 MARK DABLING BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3839
Practice Address - Country:US
Practice Address - Phone:719-592-1584
Practice Address - Fax:719-592-0965
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2009-02-18
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Provider Licenses
StateLicense IDTaxonomies
TN284182083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A72377Medicare UPIN