Healthcare Provider Details

I. General information

NPI: 1083613061
Provider Name (Legal Business Name): GEORGE C LU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 01/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW BRIARCLIFF PKWY SUITE 310
KANSAS CITY MO
64116-1878
US

IV. Provider business mailing address

1201 NW BRIARCLIFF PKWY SUITE 310
KANSAS CITY MO
64116-1878
US

V. Phone/Fax

Practice location:
  • Phone: 816-541-2700
  • Fax:
Mailing address:
  • Phone: 816-541-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number2001011419
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: