Healthcare Provider Details

I. General information

NPI: 1962516070
Provider Name (Legal Business Name): FAUST MANUEL ALVAREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 FLOWERREE
HELENA MT
59601
US

IV. Provider business mailing address

526 FLOWERREE
HELENA MT
59601
US

V. Phone/Fax

Practice location:
  • Phone: 406-443-3838
  • Fax:
Mailing address:
  • Phone: 406-447-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3433
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number3433
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: