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NPI Code Detail

MEDICARE: DENNIS T ALTER MD PA

MEDICARE: DENNIS T ALTER MD PA
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
1174400000XSpecialistME0054825FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CE8874OTHERGARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932329653
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENNIS T ALTER MD PA
Provider Business Mailing Address
First Line : 21 HOSPITAL DR
Second Line : SUITE 110
City : PALM COAST
State : FL
Zip : 32164-2380
Country : US
Telephone Number : 386-586-1370
Fax Number : 386-586-1369
Provider Business Practice Location Address
First Line : 21 HOSPITAL DR
Second Line : SUITE 110
City : PALM COAST
State : FL
Zip : 32164-2380
Country : US
Telephone Number : 386-586-1370
Fax Number : 386-586-1369
Authorized Official
Title or Position : PRESIDENT
Name : DR. DENNIS THOMAS ALTER
Credential : M.D.
Telephone Number : 386-586-1370
Provider Enumeration Date : 04/26/2007
Last Update Date : 09/17/2008

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