Provider Demographics
NPI:1407856057
Name:ALVAREZ, ANTHONY WADE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WADE
Last Name:ALVAREZ
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:PO BOX 635283
Mailing Address - Street 2:ST. ELIZABETH PHYSICIANS
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-301-5901
Mailing Address - Fax:859-301-5940
Practice Address - Street 1:820 DOLWICK DR
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-2774
Practice Address - Country:US
Practice Address - Phone:859-301-5901
Practice Address - Fax:859-301-5940
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30979207QA0401X, 2083A0300X, 2084P0800X
IN01063008A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200843210Medicaid
KY64309792Medicaid
OH2325817Medicaid
OH2325817Medicaid
IN200843210Medicaid
P00142174Medicare PIN
P00089244Medicare PIN
IN226420DMedicare PIN
KY64309792Medicaid
P00142174Medicare PIN