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NPI Code Detail

MEDICARE: ABIGAIL LUTY MD

MEDICARE: ABIGAIL LUTY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor8243-226WI

General Provider Information

NPI Number : 1588512537
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL LUTY MD
Provider Business Mailing Address
First Line : W170S8115 GREEN ST
Second Line :
City : MUSKEGO
State : WI
Zip : 53150-8811
Country : US
Telephone Number : 414-243-1183
Fax Number :
Provider Business Practice Location Address
First Line : 540 E GRAND AVE
Second Line :
City : BELOIT
State : WI
Zip : 53511-6314
Country : US
Telephone Number : 608-368-8087
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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