Provider Demographics
NPI:1861554461
Name:ALVARADO, NESTOR A (MD)
Entity type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:A
Last Name:ALVARADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 EAST JEFFERSON STREET PPQA MEDICARE COMP. UNIT 6
Mailing Address - Street 2:KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:20904 SENECA MEADOWS PKWY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7005
Practice Address - Country:US
Practice Address - Phone:240-686-3160
Practice Address - Fax:240-686-3110
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30819208000000X
MDD0050386208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
007644M92Medicare ID - Type Unspecified
G42818Medicare UPIN