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NPI Code Detail

MEDICARE: JOAN LUO M.D.

MEDICARE: JOAN LUO 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
1204C00000XSports Medicine (Neuromusculoskeletal Medicine) PhysicianD56140MD
2204C00000XSports Medicine (Neuromusculoskeletal Medicine) PhysicianVA0101225846VA
32081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianD56140MD
42081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianVA0101225846VA
52081S0010XSports Medicine (Physical Medicine & Rehabilitation) PhysicianD56140MD
62081S0010XSports Medicine (Physical Medicine & Rehabilitation) PhysicianVA0101225846VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851376651
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN LUO M.D.
Provider Business Mailing Address
First Line : 8943 SHADY GROVE CT
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20877-1308
Country : US
Telephone Number : 301-987-8988
Fax Number : 301-987-8933
Provider Business Practice Location Address
First Line : 8943 SHADY GROVE CT
Second Line :
City : GAITHERSBURG
State : MD
Zip : 20877-1308
Country : US
Telephone Number : 301-987-8988
Fax Number : 301-987-8933
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 03/04/2011

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