Provider Demographics
NPI:1992908461
Name:ALTAMAR, GUSTAVO ADOLFO (MD)
Entity type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:ADOLFO
Last Name:ALTAMAR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:H-7 VILLA ESPANA
Mailing Address - Street 2:ALCAZAR
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-765-5147
Mailing Address - Fax:787-765-5147
Practice Address - Street 1:HOSPATAL MUNICIPAL DE SAN JUAN
Practice Address - Street 2:CENTRO MEDICO DE PUERTO RICO
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-765-5147
Practice Address - Fax:787-765-5147
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2017-04-27
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Provider Licenses
StateLicense IDTaxonomies
PR17448207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine