Healthcare Provider Details

I. General information

NPI: 1003877473
Provider Name (Legal Business Name): DONALD W ALVES MD, MS, FACEP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 REISTERSTOWN ROAD MEDICAL SERVICES
BALTIMORE MD
21208-3899
US

IV. Provider business mailing address

1201 REISTERSTOWN ROAD MEDICAL SERVICES
BALTIMORE MD
21208-3899
US

V. Phone/Fax

Practice location:
  • Phone: 410-653-8366
  • Fax: 410-653-4290
Mailing address:
  • Phone: 410-653-8366
  • Fax: 410-653-4290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101057847
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD57744
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberD57744
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number0101057847
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: