Provider Demographics
NPI:1316037542
Name:ALTVATER, HAROLD L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:L
Last Name:ALTVATER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HAROLD
Other - Middle Name:LEROY
Other - Last Name:ALTVATER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:140 LINCOLN AVE
Mailing Address - Street 2:HOSPITAL ADMINISTRATION
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6700
Mailing Address - Country:US
Mailing Address - Phone:978-374-2000
Mailing Address - Fax:
Practice Address - Street 1:140 LINCOLN AVE
Practice Address - Street 2:HOSPITAL ADMINISTRATION
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6700
Practice Address - Country:US
Practice Address - Phone:978-374-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159845207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3207021Medicaid
MAA3100801Medicare PIN