Provider Demographics
NPI:1619918828
Name:ALTMAN, DANIEL WINSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WINSTON
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:188 FRIES MILL RD
Mailing Address - Street 2:SUITE E-3
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2015
Mailing Address - Country:US
Mailing Address - Phone:856-629-7006
Mailing Address - Fax:856-629-0077
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:SUITE E-3
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2015
Practice Address - Country:US
Practice Address - Phone:856-629-7006
Practice Address - Fax:856-629-0077
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO63661207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8881308Medicaid
NJH05593Medicare UPIN
NJ8881308Medicaid