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General NPI Number Information
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NPI Number | 1922029859
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Entity Type | Individual
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Provider Name | LUIS E URRUTIA MD
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 04/28/2025
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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 | 17822-2065
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Country | US
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Telephone | 570-271-6523
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE # MC4903
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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 | 570-271-6144
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C1-0012343
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00043573
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License Number State | WA
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