Healthcare Provider Details

I. General information

NPI: 1528027315
Provider Name (Legal Business Name): PETER MICHAEL DAYTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S KANNER HWY STE 200
STUART FL
34994-4801
US

IV. Provider business mailing address

1815 S KANNER HWY
STUART FL
34994
US

V. Phone/Fax

Practice location:
  • Phone: 772-419-3301
  • Fax: 772-419-3302
Mailing address:
  • Phone: 772-288-2992
  • Fax: 772-288-2999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME0046691
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: