Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 30979 | KY |
NPI | 1407856057 |
---|---|
Provider Name | Dr. Anthony Wade Alvarez |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Erlanger, KY 41018-2774 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 16/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200843210 | (05) | IN |
2325817 | (05) | OH |
64309792 | (05) | KY |
F88422 | (02) |