Healthcare Provider Details

I. General information

NPI: 1033306881
Provider Name (Legal Business Name): RUI LU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 07/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW SUITE 411 SOUTH
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

106 IRVING ST NW SUITE 411 SOUTH
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-7080
  • Fax:
Mailing address:
  • Phone: 202-877-7080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD33677
License Number StateDC

VIII. Authorized Official

Name: DR. RUI LU
Title or Position: OWENER
Credential: M.D.
Phone: 202-877-7080