1710948773 NPI number — DR. MANUEL ALVAREZ RODRIGUEZ MD

Table of content: DR. MANUEL ALVAREZ RODRIGUEZ MD (NPI 1710948773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710948773 NPI number — DR. MANUEL ALVAREZ RODRIGUEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ
Provider First Name:
MANUEL
Provider Middle Name:
ALVAREZ
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RODRIGUEZ
Provider Other First Name:
MANUEL
Provider Other Middle Name:
ALVAREZ
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
SENIOR STAFF MEDICAL
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1710948773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 666
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH SIOUX CITY
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57049-0666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-232-9600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HWY 75 77
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINNEBAGO
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-878-2231
Provider Business Practice Location Address Fax Number:
402-878-2535
Provider Enumeration Date:
03/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  21933 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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