MEDICARE: DR. CHONYANG LU ALBERT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MT200992	PA
2	207RC0000X	Cardiovascular Disease Physician	35.135809	OH
3	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	35.135809	OH

General Provider Information

NPI Number	:	1194084202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHONYANG LU ALBERT M.D.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # J3-4
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	215-803-3056
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # J3-4
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-4206
Country	:	US
Telephone Number	:	216-444-4110
Fax Number	:	216-445-6196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2012
Last Update Date	:	11/11/2020

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