Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 35098625 | OH |
N | 207QS0010X | Family Doctor - Sports Medicine | 35098625 | OH |
NPI | 1265674576 |
---|---|
Provider Name | Robert M Altenau |
First Address | Cincinnati, OH 45263-7676 |
Second Address | Cincinnati, OH 45211-6378 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 24/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0072711 | (05) | OH |