Provider Demographics
NPI:1023232014
Name:ALTMAN, SHEM (MD)
Entity type:Individual
Prefix:DR
First Name:SHEM
Middle Name:
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 N 69TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4532
Mailing Address - Country:US
Mailing Address - Phone:480-629-4008
Mailing Address - Fax:
Practice Address - Street 1:10505 N 69TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-4532
Practice Address - Country:US
Practice Address - Phone:480-629-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34477207ZP0104X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF16480Medicare UPIN