Provider Demographics
NPI:1205831005
Name:ALTMAN, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11900 E 12 MILE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-3490
Mailing Address - Country:US
Mailing Address - Phone:586-574-2800
Mailing Address - Fax:586-574-2803
Practice Address - Street 1:11900 E 12 MILE RD
Practice Address - Street 2:STE 201
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3490
Practice Address - Country:US
Practice Address - Phone:586-574-2800
Practice Address - Fax:586-574-2803
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2021-07-28
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Provider Licenses
StateLicense IDTaxonomies
MI4301056490207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI070E015730OtherBCN ADVANTAGE
MI1222960001OtherMIDWEST HEALTH PLAN
MIC3488OtherMCARE
MI070E015730OtherBCN
MION96970001OtherBCBSM MEDICARE PLUS BLUE
MI1222960001OtherTOTAL HEALTH CARE
MI4566535OtherAETNA HMO
MI4566535OtherAETNA
MI4640535Medicaid
MI52686OtherOMNICARE
MI119608OtherCARE CHOICES
MIDA056490OtherBCBSM AND BCN
MI100166OtherGREAT LAKES HEALTH
MI100738OtherMOLINA HEALTH PLAN
MI29813OtherCOMMUNITY CHOICE OF MICHI
MI119608OtherPREFERRED CHOICES
MIF22533OtherHAP
MIP00175581OtherTRAVELERS MEDICARE
MI52686OtherOMNICARE
MI4640535Medicaid