Healthcare Provider Details

I. General information

NPI: 1457387821
Provider Name (Legal Business Name): MARIA LUNA T NAVARRO, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ELK PLZ
ELKVIEW WV
25071-9602
US

IV. Provider business mailing address

PO BOX 193
CHARLESTON WV
25321-0193
US

V. Phone/Fax

Practice location:
  • Phone: 304-965-5888
  • Fax: 304-965-3882
Mailing address:
  • Phone: 304-965-5888
  • Fax: 304-965-3882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA LUNA NAVARRO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 304-965-5888