Provider Demographics
NPI:1811054489
Name:ALVAREZ, JULIE M (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:MAE
Other - Last Name:ALVAREZ GOMEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6412 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-2131
Mailing Address - Country:US
Mailing Address - Phone:913-631-2720
Mailing Address - Fax:
Practice Address - Street 1:6675 HOLMES RD
Practice Address - Street 2:SUITE 350
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1150
Practice Address - Country:US
Practice Address - Phone:816-523-6609
Practice Address - Fax:816-523-6616
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1E77207Q00000X
KS0419957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
64131A002OtherCHAMPUS TRICARE
MO202124012Medicaid
10534021OtherBLUE CROSS BLUE SHIELD OF
64131A002OtherCHAMPUS TRICARE
MO202124012Medicaid