Provider Demographics
NPI:1811192495
Name:ROSALES, ALVARO ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:ENRIQUE
Last Name:ROSALES
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 3627
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-3627
Mailing Address - Country:US
Mailing Address - Phone:907-262-4278
Mailing Address - Fax:907-802-4530
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2969
Practice Address - Country:US
Practice Address - Phone:907-262-4278
Practice Address - Fax:907-802-4530
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK108828207RC0000X, 207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1644661Medicaid
AK1644661Medicaid