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NPI Code Detail

MEDICARE: DR. DANIEL L. PETERSON DPM

MEDICARE: DR. DANIEL L. PETERSON DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist171WY

General Provider Information

NPI Number : 1437536786
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL L. PETERSON DPM
Provider Business Mailing Address
First Line : 1050 MYDLAND RD
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-2186
Country : US
Telephone Number : 307-674-7469
Fax Number : 307-674-4619
Provider Business Practice Location Address
First Line : 1050 MYDLAND RD
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-2186
Country : US
Telephone Number : 307-674-7469
Fax Number : 307-674-4619
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2015
Last Update Date : 12/08/2025

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