MEDICARE: DR. ASUNCION Q LUZ MD

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	208000000X	Pediatrics Physician	4301032216	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497758650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASUNCION Q LUZ MD

Provider Business Mailing Address
First Line	:	770 RIVERSIDE AVE
Second Line	:	SUITE 17
City	:	ADRIAN
State	:	MI
Zip	:	49221-1476
Country	:	US
Telephone Number	:	517-265-8134
Fax Number	:	517-265-2237

Provider Business Practice Location Address
First Line	:	770 RIVERSIDE AVE
Second Line	:	SUITE 17
City	:	ADRIAN
State	:	MI
Zip	:	49221-1476
Country	:	US
Telephone Number	:	517-265-8134
Fax Number	:	517-265-2237

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/29/2015

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