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1821042094

NPI Code Detail

MEDICARE: LUIS A TRUJILLO MD

MEDICARE: LUIS A TRUJILLO 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
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	071407	MI
2	208M00000X	Hospitalist Physician	071407	MI
3	207P00000X	Emergency Medicine Physician	4301071407	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0106510712	OTHER	MI	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0F71000	OTHER	MI	BCBS
5	LT071407	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1821042094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS A TRUJILLO MD

Provider Business Mailing Address
First Line	:	2510 ABBOTT RD
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48642-5006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 QUARTER ST
Second Line	:
City	:	GLADWIN
State	:	MI
Zip	:	48624-1959
Country	:	US
Telephone Number	:	989-426-9286
Fax Number	:

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	04/20/2010

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Directions to “ LUIS A TRUJILLO MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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