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General NPI Number Information
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NPI Number | 1992827869
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Entity Type | Individual
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Provider Name | DANIEL M PETERSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 5320 MARK DABLING BLVD SUITE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-3839
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Country | US
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Telephone | 719-592-1584
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Fax | 719-592-0965
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Provider Business Mailing Address
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Address Line | 2322 S ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80916-2406
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Country | US
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Telephone | 719-390-1727
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Fax | 719-390-9690
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DR.0046019
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License Number State | CO
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