Provider Demographics
NPI:1588646236
Name:ALVAREZ, DANIEL RYAN (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RYAN
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DO
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 2178
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-2178
Mailing Address - Country:US
Mailing Address - Phone:316-263-5889
Mailing Address - Fax:316-267-3601
Practice Address - Street 1:1515 S CLIFTON AVE STE 320
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2953
Practice Address - Country:US
Practice Address - Phone:316-263-5889
Practice Address - Fax:316-267-3601
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0525651207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA2075001OtherBLUE CROSS
KS100236410EMedicaid
KSKA2075001OtherBLUE CROSS
KSKA2075001Medicare PIN