Teresa Lois Alvarado, MD

Individual provider Active NPI Gynecology Physician · Jacksonville, NC

NPI 1699874602 · NPPES record last updated May 24, 2012

Key facts

NPI
1699874602
Entity type
Individual (NPI type 1)
Primary specialty
Gynecology Physician 207VG0400X
License
30273 (NC)
Practice address
219 Station Street
Jacksonville, NC 28546
Phone
(910) 455-5000
Fax
(910) 455-7083
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120726000356 NC Practitioner - Obstetrics/Gynecology 9133385743 Practice locations: Jacksonville, NC

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30273NCMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Womens Clinic Gynecology Past
since May 22, 2012
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 30273 NC Yes

Addresses

Primary practice location

219 Station Street
Jacksonville, NC 28546

Mailing address

219 Station Street
Jacksonville, NC 28546
Phone (910) 455-5000

Other identifiers

IdentifierTypeStateIssuer
561940600OtherNCTAX ID
8910996MedicaidNC

Other providers in Jacksonville, NC

All providers in Jacksonville, NC · Gynecology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.