1093871170 NPI number — DR. FRANCISCO LUGO DPM

Table of content: DR. FRANCISCO LUGO DPM (NPI 1093871170)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093871170 NPI number — DR. FRANCISCO LUGO DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUGO
Provider First Name:
FRANCISCO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093871170
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8555 16TH ST STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20910-2847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-588-4811
Provider Business Mailing Address Fax Number:
301-588-4813

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8555 16TH ST STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20910-2847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-588-4811
Provider Business Practice Location Address Fax Number:
301-588-4813
Provider Enumeration Date:
12/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  01067 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 958933 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 213616 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 071137 . This is a "ANTHEM BC OF VA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4317899 . This is a "AETNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 60560001 . This is a "BC OF DC FEDERAL" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 7020133 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5296100001 . This is a "DME MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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