Provider Demographics
NPI:1093794117
Name:ALTMAN, EMILY M (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:M
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1525 CLIFTON RD NE STE 1051
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-4200
Mailing Address - Country:US
Mailing Address - Phone:616-717-3082
Mailing Address - Fax:505-272-6228
Practice Address - Street 1:1525 CLIFTON RD. NE
Practice Address - Street 2:1ST FLOOR, SUITE 105
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:616-717-3082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2017-0772207N00000X
NJ25MA06877100207N00000X
GA101139207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG75433Medicare UPIN
NJ029038Medicare PIN