Individual provider · Type 1 NPI

Johnny Tan Lu, MD

Specialist · St. Louis, MO

NPI number 1679863278 Active

Practice location

12647 Olive Blvd
St. Louis, MO 63141-6393

Call (800) 325-3982 Map

Fax (877) 685-9866

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X0101221438 (VA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1679863278

Johnny Tan Lu, MD's National Provider Identifier is 1679863278, issued on Apr 15, 2011. The primary taxonomy on file is Specialist (174400000X), and the practice location is in St. Louis, MO. The record was last updated on Apr 15, 2011.