MEDICARE: CHLOE LUI PA-C

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
1	363A00000X	Physician Assistant	10004549A	IN

General Provider Information

NPI Number	:	1790502573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHLOE LUI PA-C

Provider Business Mailing Address
First Line	:	1118 N PARKER AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-2270
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1118 N PARKER AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-2270
Country	:	US
Telephone Number	:	812-646-5387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	09/24/2024

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Directions to “ CHLOE LUI PA-C” Practice Location

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