Provider Demographics
NPI:1457387821
Name:MARIA LUNA T NAVARRO, M.D.
Entity Type:Organization
Organization Name:MARIA LUNA T NAVARRO, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA LUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-965-5888
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25321-0193
Mailing Address - Country:US
Mailing Address - Phone:304-965-5888
Mailing Address - Fax:304-965-3882
Practice Address - Street 1:5 ELK PLZ
Practice Address - Street 2:
Practice Address - City:ELKVIEW
Practice Address - State:WV
Practice Address - Zip Code:25071-9602
Practice Address - Country:US
Practice Address - Phone:304-965-5888
Practice Address - Fax:304-965-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4387523OtherAETNA
WV0082433000Medicaid
WV0082433000Medicaid
WV9177212Medicare ID - Type UnspecifiedGROUP NO.
WV9177211Medicare ID - Type UnspecifiedCHAPMANVILLE OFFICE GROUP
WVNA0458984Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
4387523OtherAETNA