Provider Demographics
NPI:1053479592
Name:ALTMAN, M STUART (DPM)
Entity Type:Individual
Prefix:MR
First Name:M
Middle Name:STUART
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1112 DALLAS DR
Mailing Address - Street 2:STE 401
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205
Mailing Address - Country:US
Mailing Address - Phone:940-387-3411
Mailing Address - Fax:940-387-7031
Practice Address - Street 1:1112 DALLAS DR
Practice Address - Street 2:STE 401
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205
Practice Address - Country:US
Practice Address - Phone:940-387-3411
Practice Address - Fax:940-387-7031
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0389213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T11930Medicare UPIN
00JE08Medicare ID - Type Unspecified