Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME 70999 | FL |
N | 207ND0101X | MOHS-Micrographic Surgeon | ME 70999 | FL |
N | 207ND0900X | Dermatopathologist | ME 70999 | FL |
N | 207NS0135X | Procedural Dermatology | ME 70999 | FL |
NPI | 1336287994 |
---|---|
Provider Name | Dr. Melvin Chia-Hung Lu |
First Address | Weeki Wachee, FL 34613-6385 |
Second Address | Weeki Wachee, FL 34613-6385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 21/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070012943 | MEDICARE RAILROAD (01) | |
31381 | BCBS PROVIDER NUMBER (01) | |
38300 | BCBS GROUP NUMBER (01) | |
38300A | BCBS GROUP NUMBER (01) | |
CI5866 | MEDICARE RAILROAD GRP # (01) | |
G19161 | (02) |