Provider Demographics
NPI:1568463479
Name:ALTMAN, WAYNE J (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:J
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11 WATER ST
Mailing Address - Street 2:STE 1A
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4812
Mailing Address - Country:US
Mailing Address - Phone:781-648-9700
Mailing Address - Fax:781-648-0234
Practice Address - Street 1:11 WATER ST
Practice Address - Street 2:STE 1A
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4812
Practice Address - Country:US
Practice Address - Phone:781-648-9700
Practice Address - Fax:781-648-0234
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-08-24
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Provider Licenses
StateLicense IDTaxonomies
MA153014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3168786Medicaid
MA3168786Medicaid
G49653Medicare UPIN