Provider Demographics
NPI:1174509855
Name:ALVI, TAHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:TAHIR
Middle Name:
Last Name:ALVI
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 1:714 GARLAND CIR
Mailing Address - Street 2:APT A
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2456
Mailing Address - Country:US
Mailing Address - Phone:269-353-4441
Mailing Address - Fax:269-353-8333
Practice Address - Street 1:6099 SAN GABRIEL
Practice Address - Street 2:SUITE C
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-8104
Practice Address - Country:US
Practice Address - Phone:269-353-4441
Practice Address - Fax:269-353-8333
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MITA065207207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3397804Medicaid
MI0M49360Medicare ID - Type Unspecified
MI3397804Medicaid