Provider Demographics
NPI:1922105139
Name:ROBERT B ALTMEYER M D INC
Entity Type:Organization
Organization Name:ROBERT B ALTMEYER M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:ALTMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-243-1446
Mailing Address - Street 1:1131 NATIONAL ROAD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11525207RP1001X
OH35039934207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0083501000Medicaid
OH0383526Medicaid
WV0083501000Medicaid
OH0383526Medicaid
OH9924292Medicare PIN