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General NPI Number Information
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NPI Number | 1538107099
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Entity Type | Individual
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Provider Name | LINDA LOUISE LUTZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 07/07/2010
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Provider Practice Location Address
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Address Line | 419 W REDWOOD ST SUITE 160
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City | BALTIMORE
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State | MD
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Zip | 21201-1734
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Country | US
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Telephone | 410-328-3167
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Fax | 410-328-1323
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Provider Business Mailing Address
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Address Line | PO BOX 64445
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City | BALTIMORE
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State | MD
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Zip | 21264-4445
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Country | US
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Telephone | 410-328-5767
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Fax | 410-328-0098
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D26019
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License Number State | MD
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