Provider Demographics
NPI:1093794117
Name:ALTMAN, EMILY M (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:M
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:933 BRADBURY DR. SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-6222
Mailing Address - Fax:505-272-6228
Practice Address - Street 1:933 BRADBURY DR SE STE 2222
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4375
Practice Address - Country:US
Practice Address - Phone:505-272-6000
Practice Address - Fax:505-272-6228
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2017-0772207N00000X
NJ25MA06877100207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG75433Medicare UPIN
NJ029038Medicare PIN