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Individual

ALVIA MOID

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-7003
(224) 610-7005
Mailing address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-7003
(224) 610-7005

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48519
WI
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
48519-21
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43526700
WI
Enumeration date
05/26/2006
Last updated
01/20/2022
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