Provider Demographics
NPI:1609249556
Name:ALTMAN, JAMES ANTHONY
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 NATURAL WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-3780
Mailing Address - Country:US
Mailing Address - Phone:813-615-3161
Mailing Address - Fax:
Practice Address - Street 1:53 NATURAL WAY
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-3780
Practice Address - Country:US
Practice Address - Phone:813-615-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-01
Last Update Date:2015-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARRT#2759292471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography