Individual
MARTIN EDWARD LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 GROVE RD, GMH ER ADMINISTRATION, GREENVILLE, SC 29605-5611
(864) 455-6372
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11938
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119384
—
SC
01
—
167191
UNISON
SC
01
—
20-11938
SCCS
SC
01
—
20009821
SELECT HEALTH IND
SC
01
—
20061678
SELECT HEALTH GRP
SC
01
—
930119448
MEDICARE RR
SC
Enumeration date
07/25/2006
Last updated
03/07/2023
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