MEDICARE: DR. RONALD J ALVAREZ 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	174400000X	Specialist	051404	GA

General Provider Information

NPI Number	:	1487734414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD J ALVAREZ M.D.

Provider Business Mailing Address
First Line	:	80 LACY ST NW
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-1107
Country	:	US
Telephone Number	:	770-427-0368
Fax Number	:	678-581-5969

Provider Business Practice Location Address
First Line	:	2365 OLD MILTON PKWY
Second Line	:	STE 300
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-2140
Country	:	US
Telephone Number	:	770-740-1860
Fax Number	:	678-347-2104

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	12/16/2016

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