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General NPI Number Information
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NPI Number | 1891158515
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Entity Type | Individual
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Provider Name | WEI-DAR LU D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 06/20/2020
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Provider Practice Location Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-9800
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Country | US
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Telephone | 570-271-6211
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-9800
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Country | US
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Telephone | 570-271-6211
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OT017147
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OS019641
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License Number State | PA
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