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General NPI Number Information
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NPI Number | 1104139963
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Entity Type | Individual
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Provider Name | DAVID F ALTAMIRANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 2800 MAIN ST
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4201
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Country | US
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Telephone | 203-576-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 59 MICHAEL LN
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City | NAUGATUCK
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State | CT
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Zip | 06770-1556
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Country | US
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Telephone | 203-490-7918
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 051804
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License Number State | CT
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