Provider Demographics
NPI:1841256070
Name:RYES, ALVARO A (MD)
Entity type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:A
Last Name:RYES
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 1:2300 CHAMBER CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAKESIDE PARK
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1686
Mailing Address - Country:US
Mailing Address - Phone:800-222-3577
Mailing Address - Fax:859-282-1141
Practice Address - Street 1:7600 AFFINITY DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3535
Practice Address - Country:US
Practice Address - Phone:800-222-3577
Practice Address - Fax:859-282-1141
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074794207RN0300X
IN01052489A207RN0300X
KY34777207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64347776Medicaid
IN200267730Medicaid
OH2092980Medicaid
KY64347776Medicaid
OHH014710Medicare PIN
INM300051735Medicare PIN
OHH014710Medicare PIN