Provider Demographics
NPI:1952425985
Name:ALTMAN, ALAN LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEONARD
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10896
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87184
Mailing Address - Country:US
Mailing Address - Phone:505-269-1937
Mailing Address - Fax:505-247-3265
Practice Address - Street 1:9132 4TH ST NW
Practice Address - Street 2:PO BOX 10896
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114
Practice Address - Country:US
Practice Address - Phone:505-269-1937
Practice Address - Fax:505-247-3265
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM81-143207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000035477Medicaid
NM000035477Medicaid
NM2108195Medicare PIN