Provider Demographics
NPI:1760586150
Name:NEGRON-MEDINA, RAFAEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:E
Last Name:NEGRON-MEDINA
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:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-1554
Mailing Address - Country:US
Mailing Address - Phone:919-690-3020
Mailing Address - Fax:919-690-0525
Practice Address - Street 1:103 PROFESSIONAL PARK STE C
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-2581
Practice Address - Country:US
Practice Address - Phone:919-690-3020
Practice Address - Fax:919-690-0525
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200800411207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR600457OtherMMM
PR060019OtherCRUZ AZUL DE PR
PR2002191OtherACAA
PR6740046OtherHUMANA
PR3179OtherPREFERRED MEDICARE CHOICE
PR0335OtherFIRST MEDICAL CARD
PR88478OtherTRIPLE SSS
PR202069OtherPREFERED HEALTH
PR88478OtherTRIPLE C
PR6740046OtherHUMANA
PR88478Medicare ID - Type Unspecified