Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 17836 | NH |
N | 2084N0400X | Neurologist | 2016-00670 | NC |
N | 2084N0400X | Neurologist | 29193 | NE |
N | 2084N0400X | Neurologist | 292709 | NY |
N | 2084N0400X | Neurologist | 4301114445 | MI |
Y | 2084N0400X | Neurologist | MD127398 | FL |
N | 2084N0400X | Neurologist | MD60365989 | WA |
N | 2084N0400X | Neurologist | N2178 | TX |
NPI | 1003017427 |
---|---|
Provider Name | Stanley Garken Lue |
First Address | Fort Myers, FL 33919-3244 |
Second Address | Fort Myers, FL 33919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 06/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
284386401 | (05) | TX |
284386402 | (05) | TX |
3115768 | (05) | NH |
P01029758 | RAILROAD (01) | TX |