Healthcare Provider Details

I. General information

NPI: 1952840092
Provider Name (Legal Business Name): CARLOS MANUEL ALVAREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date: 06/30/2018
Reactivation Date: 07/25/2018

III. Provider practice location address

201 CEDAR ST SE STE 5630
ALBUQUERQUE NM
87106-4920
US

IV. Provider business mailing address

PO BOX 26666
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-563-6399
  • Fax: 505-563-6680
Mailing address:
  • Phone: 505-563-6399
  • Fax: 505-563-6680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD2025-0418
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: