MEDICARE: MANUEL CHAVARRI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	4301034224	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110026567	OTHER	MI	RR MEDICARE
5	P5687001	OTHER	MI	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1100410341	OTHER	MI	BCBSM INDIVIDUAL #
4	1100410711	OTHER	MI	BCBSM NEW PIN
6	MC034224	OTHER	MI	STATE LICENSE

General Provider Information

NPI Number	:	1033102132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANUEL CHAVARRI M.D.

Provider Business Mailing Address
First Line	:	1035 W WASHINGTON AVE
Second Line	:
City	:	ALPENA
State	:	MI
Zip	:	49707-2929
Country	:	US
Telephone Number	:	989-358-0673
Fax Number	:

Provider Business Practice Location Address
First Line	:	346 LONG RAPIDS PLZ
Second Line	:
City	:	ALPENA
State	:	MI
Zip	:	49707-1374
Country	:	US
Telephone Number	:	989-358-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	02/22/2021

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Directions to “ MANUEL CHAVARRI M.D.” Practice Location

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