Healthcare Provider Details

I. General information

NPI: 1033102132
Provider Name (Legal Business Name): MANUEL CHAVARRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346 LONG RAPIDS PLZ
ALPENA MI
49707-1374
US

IV. Provider business mailing address

1035 W WASHINGTON AVE
ALPENA MI
49707-2929
US

V. Phone/Fax

Practice location:
  • Phone: 989-358-3500
  • Fax:
Mailing address:
  • Phone: 989-358-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number4301034224
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: