Provider Demographics
NPI:1750517215
Name:TENSMEYER, DANIEL FOULGER (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FOULGER
Last Name:TENSMEYER
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 1:1030 MEDICAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-3119
Mailing Address - Country:US
Mailing Address - Phone:435-723-9700
Mailing Address - Fax:
Practice Address - Street 1:1030 MEDICAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3119
Practice Address - Country:US
Practice Address - Phone:435-723-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9436045-1205207X00000X
MI4301094461390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery