Provider Demographics
NPI:1164464194
Name:ALVEAR, JORGE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:R
Last Name:ALVEAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 GLENRIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SANDY SPGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5579
Mailing Address - Country:US
Mailing Address - Phone:404-816-3000
Mailing Address - Fax:404-946-0404
Practice Address - Street 1:5730 GLENRIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:SANDY SPGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-816-3000
Practice Address - Fax:404-946-0404
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052109207L00000X, 208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000970274BMedicaid
GA00970274AMedicaid
GA2021056909Medicare PIN
GA72BBBBMMedicare ID - Type Unspecified
GA00970274AMedicaid