Healthcare Provider Details

I. General information

NPI: 1518766435
Provider Name (Legal Business Name): LUX MEDSPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5165 W WOODMILL DR STE 15
WILMINGTON DE
19808-4067
US

IV. Provider business mailing address

5165 W WOODMILL DR STE 15
WILMINGTON DE
19808-4067
US

V. Phone/Fax

Practice location:
  • Phone: 302-660-7200
  • Fax: 302-543-5644
Mailing address:
  • Phone: 302-660-7200
  • Fax: 302-543-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ASMA MIAN
Title or Position: MD
Credential:
Phone: 302-660-7200