Provider Demographics
NPI:1851264972
Name:ALTER, BENJAMIN
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:ALTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19224 W WITTY RD
Mailing Address - Street 2:
Mailing Address - City:ELMORE
Mailing Address - State:OH
Mailing Address - Zip Code:43416-9787
Mailing Address - Country:US
Mailing Address - Phone:419-360-8359
Mailing Address - Fax:
Practice Address - Street 1:19224 W WITTY RD
Practice Address - Street 2:
Practice Address - City:ELMORE
Practice Address - State:OH
Practice Address - Zip Code:43416-9787
Practice Address - Country:US
Practice Address - Phone:419-360-8359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant