Individual
DR. HUGO G ALTAMIRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
745 N 500 W, #200, PROVO, UT 84601-1472
(801) 375-9292
Mailing address
745 N 500 W, #200, PROVO, UT 84601-1472
(801) 375-9292
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
50191281205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107010628101
IHC
UT
01
—
1200737
UNITED HEALTHCARE
UT
01
—
50191281200001
BLUE CROSS BLUE SHIELD
UT
01
—
QM0000058767
ALTIUS
UT
Enumeration date
11/08/2005
Last updated
11/06/2007
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