MEDICARE: ALEXANDER ALTMIRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA066253	PA

General Provider Information

NPI Number	:	1225851462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER ALTMIRE

Provider Business Mailing Address
First Line	:	414 THREE DEGREE RD
Second Line	:
City	:	RENFREW
State	:	PA
Zip	:	16053-1222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 ONEIDA VALLEY RD
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-2252
Country	:	US
Telephone Number	:	833-995-0116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	12/11/2025

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Directions to “ ALEXANDER ALTMIRE ” Practice Location

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