Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH7643 | FL |
NPI | 1134236946 |
---|---|
Provider Name | Douglas Altman |
First Address | Naples, FL 34108-1829 |
Second Address | Naples, FL 34108-1829 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 01/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
381798900 | (05) | FL |
88546 | BCBS OF FLORIDA (01) | FL |
U85018 | (02) | FL |