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NPI Code Detail

MEDICARE: MR. TREIS R LUM DO

MEDICARE:  MR. TREIS R LUM  DO
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
1208D00000XGeneral Practice Physician1261AZ

General Provider Information

NPI Number : 1326096256
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TREIS R LUM DO
Provider Business Mailing Address
First Line : 12366 W. MILTON DR.
Second Line :
City : PEORIA
State : AZ
Zip : 85383-7614
Country : US
Telephone Number : 928-501-9581
Fax Number : 928-501-9582
Provider Business Practice Location Address
First Line : 20950 N TATUM BLVD
Second Line : SUITE 190
City : PHOENIX
State : AZ
Zip : 85050-4200
Country : US
Telephone Number : 480-776-0022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 10/16/2010

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Directions to “ MR. TREIS R LUM DO” Practice Location

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