Provider Demographics
NPI:1720128358
Name:ALTMAN, EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BISHOP ST
Mailing Address - Street 2:SUITE 1125
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3429
Mailing Address - Country:US
Mailing Address - Phone:808-587-7077
Mailing Address - Fax:808-587-7076
Practice Address - Street 1:1001 BISHOP ST
Practice Address - Street 2:SUITE 1125
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3429
Practice Address - Country:US
Practice Address - Phone:808-587-7077
Practice Address - Fax:808-587-7076
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD - 24722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03413202Medicaid
HIC98707Medicare UPIN
HI0000BDCZQMedicare ID - Type Unspecified