MEDICARE: JOSE ALVAREZ MSW

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	1041C0700X	Clinical Social Worker	49	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10994	OTHER	NC	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1992787378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE ALVAREZ MSW

Provider Business Mailing Address
First Line	:	107 FALKENER DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5509
Country	:	US
Telephone Number	:	336-854-0818
Fax Number	:	336-282-6750

Provider Business Practice Location Address
First Line	:	3817 LAWNDALE DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1641
Country	:	US
Telephone Number	:	336-282-6626
Fax Number	:	336-282-6750

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

Provider Enumeration Date	:	11/19/2005
Last Update Date	:	07/08/2007

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