Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 54970-20 | WI |
Y | 208600000X | Surgeon | 54970-20 | WI |
N | 2082S0105X | Plastic Hand Surgeon | 54970-20 | WI |
N | 2082S0105X | Plastic Hand Surgeon | A128002 | CA |
NPI | 1518197326 |
---|---|
Provider Name | Andrew D Navarrete |
First Address | Milwaukee, WI 53215-3669 |
Second Address | Milwaukee, WI 53215-3669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2009 |
Last Update Date | 15/12/2021 |