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General NPI Number Information
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NPI Number | 1790065456
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Entity Type | Organization
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Legal Business Name | IRVING A. LUGO, M.D., P.A.
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | 2311 W CONE BLVD SUITE 235
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City | GREENSBORO
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State | NC
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Zip | 27408-4042
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Country | US
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Telephone | 336-288-6440
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 W CONE BLVD SUITE 235
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City | GREENSBORO
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State | NC
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Zip | 27408-4042
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Country | US
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Telephone | 336-288-6440
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. IRVING A LUGO
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Credential | MD
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Telephone | 336-288-6440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 30835
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License Number State | NC
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