MEDICARE: DANIEL RYAN ALVAREZ DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	0525651	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	KA2075001	OTHER	KS	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588646236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL RYAN ALVAREZ DO

Provider Business Mailing Address
First Line	:	PO BOX 2178
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67201-2178
Country	:	US
Telephone Number	:	316-263-5889
Fax Number	:	316-267-3601

Provider Business Practice Location Address
First Line	:	1515 S CLIFTON AVE STE 320
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-2953
Country	:	US
Telephone Number	:	316-263-5889
Fax Number	:	316-267-3601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	10/17/2011

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