Provider Demographics
NPI:1790763324
Name:ALVAREZ-MORALES, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:ALVAREZ-MORALES
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 1:220 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-1518
Mailing Address - Country:US
Mailing Address - Phone:781-982-1021
Mailing Address - Fax:
Practice Address - Street 1:179 QUINCY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2959
Practice Address - Country:US
Practice Address - Phone:508-427-7700
Practice Address - Fax:508-427-7755
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73816208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9780122Medicaid
MA9780122Medicaid