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NPI Code Detail

MEDICARE: NANCY ALTAMIRANO MD

MEDICARE: NANCY ALTAMIRANO 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
1208000000XPediatrics Physician0101056004VA
2208000000XPediatrics PhysicianMD190330OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C09463OTHERVAGROUP PTAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932159159
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY ALTAMIRANO MD
Provider Business Mailing Address
First Line : 1900 WOODLAND DR
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2099
Country : US
Telephone Number : 541-267-5151
Fax Number : 541-266-4566
Provider Business Practice Location Address
First Line : 1900 WOODLAND DR
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2099
Country : US
Telephone Number : 541-267-5151
Fax Number : 541-266-4566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 08/06/2019

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Directions to “ NANCY ALTAMIRANO MD” Practice Location

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