Provider Demographics
NPI:1467488445
Name:ALTMANSHOFER, BERT J (DPM)
Entity Type:Individual
Prefix:
First Name:BERT
Middle Name:J
Last Name:ALTMANSHOFER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-0412
Mailing Address - Country:US
Mailing Address - Phone:814-696-3397
Mailing Address - Fax:
Practice Address - Street 1:1798 OLD ROUTE 220 N
Practice Address - Street 2:SUITE 201
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8341
Practice Address - Country:US
Practice Address - Phone:814-696-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002818L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
145696H59OtherUMWA
681677OtherADVANTRA FREEDOM
316039OtherHEALTHAMERI HEALTHASSURAN
145696OtherBLUE CROSS BLUE SHIELD
200088OtherUPMC
242968OtherALLIANCE
2958931OtherAETNA
242968OtherMAMSI
681677OtherADVANTRA FREEDOM
145696H59Medicare PIN