MEDICARE: DR. CARLOS ALVARADO M.D.

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	207P00000X	Emergency Medicine Physician	9400010	NC
2	207P00000X	Emergency Medicine Physician	0101239381	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	127VM	OTHER	NC	BCBS OF NC GRP# 015CK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	D1496	OTHER	NC	MEDCOST # DR ALVARADO
4	2281298C	OTHER	NC	CHAMPUS GRP #050588771001

General Provider Information

NPI Number	:	1679572903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS ALVARADO M.D.

Provider Business Mailing Address
First Line	:	460 MCLAWS CIR
Second Line	:	SUITE 220
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-5671
Country	:	US
Telephone Number	:	757-221-7111
Fax Number	:	757-221-8085

Provider Business Practice Location Address
First Line	:	301 MONTICELLO AVE
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-2833
Country	:	US
Telephone Number	:	757-984-6000
Fax Number	:

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/09/2007

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Directions to “ DR. CARLOS ALVARADO M.D.” Practice Location

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