Healthcare Provider Details

I. General information

NPI: 1437501079
Provider Name (Legal Business Name): WILLIAM ANDRES ALVAREZ SUAREZ MD,DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 CONGRESS PKWY S PH 423
ATHENS TN
37303-2803
US

IV. Provider business mailing address

400 S OLD WOODWARD AVE STE 300
BIRMINGHAM MI
48009-1797
US

V. Phone/Fax

Practice location:
  • Phone: 423-381-6199
  • Fax:
Mailing address:
  • Phone: 857-241-8185
  • Fax: 857-241-8185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number46527
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number13272
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDN30870
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number25523
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4351052050
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN1857507
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: