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General NPI Number Information
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NPI Number | 1154704500
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Entity Type | Individual
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Provider Name | KEVIN LU MD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 704 TRAL ST UNIT B
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City | NASHVILLE
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State | TN
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Zip | 37208-3349
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Country | US
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Telephone | 847-420-2908
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Fax |
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Provider Business Mailing Address
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Address Line | 108 CITY VIEW CT NE
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City | ATLANTA
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State | GA
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Zip | 30308-2403
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 57550
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 79263
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License Number State | GA
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