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General NPI Number Information
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NPI Number | 1013194182
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Entity Type | Organization
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Legal Business Name | MANUEL R CHAVARRI, MD, PLLC
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 04/02/2012
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Provider Practice Location Address
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Address Line | 108 S FIRST AVE
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City | ALPENA
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State | MI
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Zip | 49707-2812
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Country | US
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Telephone | 989-354-8500
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Fax | 989-354-8200
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Provider Business Mailing Address
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Address Line | 108 S FIRST AVE
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City | ALPENA
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State | MI
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Zip | 49707-2812
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Country | US
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Telephone | 989-354-8500
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Fax | 989-354-8200
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANUEL R CHAVARRI
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Credential | MD, FACE
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Telephone | 989-657-2925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MC034224
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License Number State | MI
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