Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MA20655 | NJ |
NPI | 1235200387 |
---|---|
Provider Name | Dr. George William Lutz |
First Address | Warren, NJ 07059-2632 |
Second Address | Warren, NJ 07059-2632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2006 |
Last Update Date | 08/07/2007 |