Provider Demographics
NPI:1780792887
Name:ALVAREZ, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
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 2290
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54221-2290
Mailing Address - Country:US
Mailing Address - Phone:920-320-2591
Mailing Address - Fax:
Practice Address - Street 1:1900 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-9662
Practice Address - Country:US
Practice Address - Phone:920-320-6212
Practice Address - Fax:920-684-5548
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46006207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI14832OtherNETWORK HEALTH PLAN
WI34429800Medicaid
WIP00088531OtherRAILROAD MEDICARE
WIH96061OtherCIGNA
WI390806395OtherANTHEM
WI46006OtherTOUCHPOINT
WI14832OtherNETWORK HEALTH PLAN
WI34429800Medicaid