Provider Demographics
NPI:1215911151
Name:NEGRETE, HILMER O (MD)
Entity type:Individual
Prefix:
First Name:HILMER
Middle Name:O
Last Name:NEGRETE
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 1:807 SOUTHWESTERN RUN
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3688
Mailing Address - Country:US
Mailing Address - Phone:330-729-0059
Mailing Address - Fax:330-729-9297
Practice Address - Street 1:807 SOUTHWESTERN RUN
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3688
Practice Address - Country:US
Practice Address - Phone:330-729-0059
Practice Address - Fax:330-729-9297
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086900207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2600064Medicaid
OH2600064Medicaid
OHG65660Medicare UPIN