Basic Information
Provider Information
NPI: 1396914008
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALVEY
FirstName: RUDOLF
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2829 UNIVERSITY AVE SE STE 730
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554143279
CountryCode: US
TelephoneNumber: 6128636590
FaxNumber:  
Practice Location
Address1: 333 SMITH AVE N
Address2: DEPARTMENT OF EMERGENCY MEDICINE
City: SAINT PAUL
State: MN
PostalCode: 55102
CountryCode: US
TelephoneNumber: 6512418000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/27/2008
LastUpdateDate: 07/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X55972-20WIN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X01062465AINN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X105591MNY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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