Provider Demographics
NPI:1427012525
Name:ALTMAN, ARTHUR A (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:A
Last Name:ALTMAN
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 1:3533 SOUTHERN BLVD
Mailing Address - Street 2:SUITE 4600
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429
Mailing Address - Country:US
Mailing Address - Phone:937-296-0167
Mailing Address - Fax:937-297-2330
Practice Address - Street 1:3533 SOUTHERN BLVD
Practice Address - Street 2:SUITE 4600
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429
Practice Address - Country:US
Practice Address - Phone:937-296-0167
Practice Address - Fax:937-297-2330
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043084A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2008679Medicaid
OH35043084AOtherSTATE LICENSE
000000009331OtherANTHEM PIN
AA8608727OtherDEA
OH2008679Medicaid
A15121Medicare UPIN