MEDICARE: WILFREDO A. NEGRON, MD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician

General Provider Information

NPI Number	:	1558998070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILFREDO A. NEGRON, MD, LLC

Provider Business Mailing Address
First Line	:	5354 REYNOLDS ST STE 304
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6010
Country	:	US
Telephone Number	:	912-355-7303
Fax Number	:

Provider Business Practice Location Address
First Line	:	5354 REYNOLDS ST STE 304
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6010
Country	:	US
Telephone Number	:	912-355-7303
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILFREDO A NEGRON
Credential	:	MD
Telephone Number	:	910-467-9916

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	09/23/2022

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