Provider Demographics
NPI:1487633939
Name:NAVARRO, MARIA LUNA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LUNA
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CURTIS PRICE WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-1824
Mailing Address - Country:US
Mailing Address - Phone:304-926-2200
Mailing Address - Fax:304-926-2238
Practice Address - Street 1:101 KENNA DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-2634
Practice Address - Country:US
Practice Address - Phone:304-926-2200
Practice Address - Fax:304-926-2238
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11708207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0082433000Medicaid
WVWV0800AMedicare UPIN
WVD91205Medicare UPIN
WV0082433000Medicaid