Provider Demographics
NPI:1861486797
Name:VALLE, ALVARO A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:A
Last Name:VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:979 E 3RD ST
Mailing Address - Street 2:STE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-267-0466
Mailing Address - Fax:423-757-0703
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:STE 300
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-267-0466
Practice Address - Fax:423-757-0703
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2019-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD2012208600000X
TNMD202122086X0206X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
122987OtherBCBS OF TN
TNQ002561Medicaid
020041406OtherRR MEDICARE
1740028OtherUHC
GA00445959BMedicaid
62165877408OtherJDH
AL009206950Medicaid
7090970 003OtherCIGNA
1740028OtherUHC
E57746Medicare UPIN
GA00445959BMedicaid