Provider Demographics
NPI:1558461285
Name:ALTMEYER, ROBERT B (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:ALTMEYER
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:PO BOX 6411
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0807
Mailing Address - Country:US
Mailing Address - Phone:304-243-1446
Mailing Address - Fax:304-243-1448
Practice Address - Street 1:1131 NATIONAL ROAD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-243-1446
Practice Address - Fax:304-243-1448
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11525207RP1001X
OH35039934207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0440986OtherMEDICARE
OH0383526OtherMEDICAID
WV0083501000Medicaid
WV0440985Medicare ID - Type Unspecified
A71983Medicare UPIN