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Individual
JOHN M. ALTIC
Active
Individual
JOHN M. ALTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2502
AZ
363AM0700X
Medical Physician Assistant
2502
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
726713
—
AZ
Enumeration date
06/28/2006
Last updated
01/11/2011
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