Provider Demographics
NPI:1376648238
Name:NAVARRO, EMILIO R (MD)
Entity Type:Individual
Prefix:
First Name:EMILIO
Middle Name:R
Last Name:NAVARRO
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 1:599 N CHURCH ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-1004
Mailing Address - Country:US
Mailing Address - Phone:724-542-8100
Mailing Address - Fax:
Practice Address - Street 1:599 N CHURCH ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1004
Practice Address - Country:US
Practice Address - Phone:724-542-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054292L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000928925OtherBLUESHIELD PROVIDER NUMBE
PA01578490Medicaid
PA539019Medicare ID - Type UnspecifiedPROVIDER NUMBER
PAF91132Medicare UPIN