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NPI Code Detail

MEDICARE: DR. RICARDO ERNESTO ALVILLAR M.D.

MEDICARE: DR. RICARDO ERNESTO ALVILLAR 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
1207RR0500XRheumatology Physician5505SD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00146501OTHERSDRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12197720OTHERSDAMERICAS PPO
238042OTHERSDSIOUX VALLEY HEALTH PLAN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
54995260OTHERSDBCBS
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
75505OTHERSDDAKOTACARE

General Provider Information

NPI Number : 1386694255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICARDO ERNESTO ALVILLAR M.D.
Provider Business Mailing Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5462
Country : US
Telephone Number : 605-342-3280
Fax Number : 605-721-8458
Provider Business Practice Location Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5462
Country : US
Telephone Number : 605-342-3280
Fax Number : 605-721-8458
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 07/03/2008

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