Individual
DR. JUAN M ALVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 SHACKELFORD RD, FLORISSANT, MO 63031-4369
(314) 921-4420
(314) 921-6086
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-4369
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R7H86
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00035720
RAILRAOD MEDICARE
MO
Enumeration date
02/14/2006
Last updated
10/19/2020
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