Provider Demographics
NPI:1750301677
Name:ALTER, STUART J (DPM)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:J
Last Name:ALTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1401 SPRINGHILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-3204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 SPRINGHILL AVENUE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3204
Practice Address - Country:US
Practice Address - Phone:251-432-3338
Practice Address - Fax:251-432-3330
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0150213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000076385OtherPTAN
AL051076385OtherBLUE CROSS/BLUE SHIELDS
AL631175835OtherUNITED HEALTH/MEDICARE CO
AL631175835OtherUNITED HEALTH/MEDICARE CO
AL000076385OtherPTAN