Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD033698L | PA |
NPI | 1174528533 |
---|---|
Provider Name | Dr. Domingo T Alvear |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Lemoyne, PA 17043-1168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 12/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006399930001 | (05) | PA |
0006399930005 | (05) | PA |
01605301 | BLUE CROSS (01) | PA |
AL128403 | BLUE SHIELD (01) | PA |
C31053 | (02) | PA |