Healthcare Provider Details

I. General information

NPI: 1841256070
Provider Name (Legal Business Name): ALVARO A RYES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 AFFINITY DR
CINCINNATI OH
45231-3535
US

IV. Provider business mailing address

2300 CHAMBER CENTER DR SUITE 300
LAKESIDE PARK KY
41017-1686
US

V. Phone/Fax

Practice location:
  • Phone: 800-222-3577
  • Fax: 859-282-1141
Mailing address:
  • Phone: 800-222-3577
  • Fax: 859-282-1141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35074794
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number01052489A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number34777
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: