Provider Demographics
NPI:1861870859
Name:ALTEPETER, DANIEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:ALTEPETER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FLOWER VALLEY SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-1644
Mailing Address - Country:US
Mailing Address - Phone:314-831-8400
Mailing Address - Fax:847-396-2871
Practice Address - Street 1:1 FLOWER VALLEY SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-1644
Practice Address - Country:US
Practice Address - Phone:314-831-8400
Practice Address - Fax:847-396-2871
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012025385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist