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Individual
MICHAEL DENNIS LUTZ
Active
Individual
MICHAEL DENNIS LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
100642
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100642
STATE LICENSE NO
NC
Enumeration date
01/23/2007
Last updated
07/08/2007
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