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Individual

DAVID P. ALTHAUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2619 STATE ROUTE 850, BIDWELL, OH 45614-9288
(740) 446-5148
(740) 446-5150
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5804
(740) 446-5150

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35-06-3575
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000007209
ANTHEM BCBS
01
000000190710
UNISON MEDICAID
OH
01
001714078
MOUNTAIN STATE BCBS
05
0102680000
WV
01
0885001
MOLINA MEDICAID
OH
01
220010795
RR MEDICARE
WV
01
220010796
RR MEDICARE
OH
Enumeration date
05/19/2006
Last updated
08/07/2014
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