Provider Demographics
NPI:1851341960
Name:PEREZ-NAVARRO, PAUL A (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:PEREZ-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:PO BOX 3209
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27895-3209
Mailing Address - Country:US
Mailing Address - Phone:252-243-7161
Mailing Address - Fax:252-243-7242
Practice Address - Street 1:2605 FOREST HILLS RD SW STE D
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4448
Practice Address - Country:US
Practice Address - Phone:252-243-7161
Practice Address - Fax:252-243-7242
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100590207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1288TOtherBLUE CROSS BLUE SHIELD
NC891288TMedicaid
NCG37694Medicare UPIN
NC2288257Medicare ID - Type Unspecified
NC891288TMedicaid