Healthcare Provider Details

I. General information

NPI: 1184245292
Provider Name (Legal Business Name): LUIS GERMAN TRUJILLO ARVIZU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEDICAL CENTER DR STE 410
SPRINGFIELD MA
01107-1273
US

IV. Provider business mailing address

2 MEDICAL CENTER DR STE 410
SPRINGFIELD MA
01107-1273
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-7095
  • Fax:
Mailing address:
  • Phone: 413-748-7095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number1026239
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: