Doctor Name: | MATTHEW HENRY OLTMANNS |
NPI Number: | 1063603322 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | TRN11433 |
Business Practice Address: | 1201 11th Ave S Suite 300 Birmingham, AL - 352053410 |
Business Phone Number: | 2059332625 |
Business Fax Number: | 2055582553 |
Mailing Address: | 1201 11th Ave S, Suite 300 BIRMINGHAM |
State: | AL |
Postal Code: | 352053410 |
Phone Number: | 2059332625 |
Fax Number: | 2055582553 |
NPI Enumeration Date: | 08/01/2007 |
NPI Last Update Date: | 07/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | TRN11433 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |