Provider Demographics
NPI:1679989263
Name:NAVARRETE, JOSE WILFRIDO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:WILFRIDO
Last Name:NAVARRETE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:509 N BRIGHTLEAF BLVD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4407
Mailing Address - Country:US
Mailing Address - Phone:919-938-7189
Mailing Address - Fax:919-934-1761
Practice Address - Street 1:509 N BRIGHTLEAF BLVD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4407
Practice Address - Country:US
Practice Address - Phone:919-938-7189
Practice Address - Fax:919-934-1761
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA7381207R00000X
NC2022-01074208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine