Provider Demographics
NPI:1174586200
Name:ALTMAN, MICHAEL E (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:DEPT OF CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5524
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:2411 W BELVEDERE AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5228
Practice Address - Country:US
Practice Address - Phone:410-601-8617
Practice Address - Fax:410-601-6284
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD50854207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG08700Medicare UPIN
MDS572672RMedicare PIN