Provider Demographics
NPI:1447272646
Name:HANSEN, PETER LOWELL (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:LOWELL
Last Name:HANSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:115 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:IDAHO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80452-0000
Mailing Address - Country:US
Mailing Address - Phone:303-649-3690
Mailing Address - Fax:303-649-3691
Practice Address - Street 1:7625 W 92ND AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-4567
Practice Address - Country:US
Practice Address - Phone:303-252-7790
Practice Address - Fax:303-650-2287
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2021-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO29595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE27277Medicare UPIN