Basic Information
| Provider Information | |||||||||
| NPI: | 1659328615 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRAISER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 712 SOUTH CASCADE STREET | ||||||||
| Address2: | |||||||||
| City: | FERGUS FALLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 565372813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2187368000 | ||||||||
| FaxNumber: | 2187368757 | ||||||||
| Practice Location | |||||||||
| Address1: | 712 SOUTH CASCADE STREET | ||||||||
| Address2: | |||||||||
| City: | FERGUS FALLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 565372813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2187368000 | ||||||||
| FaxNumber: | 2187368757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 02/16/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 40182 | MN | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | HP23753 | 01 | MN | HEALTHPARTNERS - FFMG | OTHER | 12Q73TR | 01 | MN | BLUE SHIELD OF MINNESOTA | OTHER | 137722100 | 05 | MN | MEDICAID | 41091744413 | 05 | NE | MEDICAID | 120900 | 01 | MN | UCARE - FFMG | OTHER | HP23753 | 01 | MN | HEALTHPARTNERS | OTHER | 06R74TR | 01 | MN | BCBS FFMG | OTHER | 1014439 | 01 | FM | PREFERREDONE | OTHER | 120900 | 01 | MN | UCARE MINNESOTA | OTHER | 15-51982 | 01 | FM | UNITED BEHAVIORAL HEALTH | OTHER | 16-00188 | 01 | MN | MEDICA - FFMG | OTHER | 1014439 | 01 | MN | PREFERRED ONE - FFMG | OTHER |