Johnny Tan Lu M.D.

NPI 1679863278 - Specialist - 174400000X

NPI Details
NPI 1679863278
Gender Male
Enumeration Date 04/15/2011
Last Updated 04/15/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
12647 OLIVE BLVD
SAINT LOUIS MO, 63141-6393, US
Phone (800) 325-3982
Fax (877) 685-9866
Business Location
12647 OLIVE BLVD
SAINT LOUIS MO, 63141-6393, US
Phone (800) 325-3982
Fax (877) 685-9866
Toxanomy
Taxonomy Code 174400000X
License State Virginia
License Number 0101221438
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According to our database, Dr. Johnny Tan Lu M.D. NPI is 1679863278, taxonomy code is 174400000X and license number is 0101221438, license state is located at Virginia. Johnny Tan Lu M.D. physically located at 12647 Olive Blvd, Saint Louis MO, 63141-6393. NPI Number Johnny Tan Lu M.D. has the Individual type.

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1679863278 NPI number is provided on an as is basis without warranty of any kind. 1679863278 is maintained by the National Plan & Provider Enumeration System. The contents of Johnny Tan Lu M.D. are for informational purposes only.