MEDICARE: DORIS L ALTHERR MD

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	207R00000X	Internal Medicine Physician	037854	CT

Other Identifiers

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

General Provider Information

NPI Number	:	1881680775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIS L ALTHERR MD

Provider Business Mailing Address
First Line	:	PO BOX 2828
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06011-2828
Country	:	US
Telephone Number	:	860-585-3906
Fax Number	:	860-585-3907

Provider Business Practice Location Address
First Line	:	7 N WASHINGTON ST
Second Line	:
City	:	PLAINVILLE
State	:	CT
Zip	:	06062-1957
Country	:	US
Telephone Number	:	860-314-6886
Fax Number	:	860-314-6889

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	02/28/2011

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