Provider Demographics
NPI:1225072812
Name:ALTER, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:ALTER
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 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-7670
Mailing Address - Fax:651-254-7676
Practice Address - Street 1:401 PHALEN BLVD - MS 41102D
Practice Address - Street 2:HEALTHPARTNERS SPECIALTY CENTER 401
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-5302
Practice Address - Country:US
Practice Address - Phone:651-254-7670
Practice Address - Fax:651-254-7676
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40442207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN48-00478OtherMEDICA CHOICE
MNHP27672OtherHEALTHPARTNERS
MN41-00006OtherMEDICA PRIMARY
MNB700OtherCHAMPUS/TRIWEST
IA0714345Medicaid
WI34365000Medicaid
MN151468OtherUCARE
MN707T3ALOtherBCBS
MN293027700Medicaid
P00292274OtherRAILROAD MEDICARE
MT0149383Medicaid
MN1019748OtherPREFERRED ONE
MN824483OtherARAZ
MT0149383Medicaid
MNP00292274Medicare ID - Type UnspecifiedRAILROAD MEDICARE