NPI Code Details Logo

NPI 1679059661

NPI 1679059661 : LIANG LU PHD, MD : LEBANON, NH

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1679059661
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    LIANG LU PHD, MD
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/13/2018
-----------------------------------------------------
    Last Update Date     |    10/09/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1 MEDICAL CENTER DR 
-----------------------------------------------------
    City                 |    LEBANON
-----------------------------------------------------
    State                |    NH
-----------------------------------------------------
    Zip                  |    03756-0001
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    603-650-5000
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    660 S EUCLID AVE 
-----------------------------------------------------
    City                 |    SAINT LOUIS
-----------------------------------------------------
    State                |    MO
-----------------------------------------------------
    Zip                  |    63110-1010
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    341-362-5000
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207ZP0102X
-----------------------------------------------------
    Taxonomy Name        |    Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
    License Number       |    2018020039
-----------------------------------------------------
    License Number State |    MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    207ZP0102X
-----------------------------------------------------
    Taxonomy Name        |    Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
    License Number       |    24625
-----------------------------------------------------
    License Number State |    NH
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.