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Individual

MELANIE BROOKE LUTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3034
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
138H1
BCBS NC
NC
01
187212
MEDCOST
NC
01
4579748
CIGNA
NC
01
807329
PARTNERS
NC
05
89138H1
NC
01
P00363054
RAILRAOD-MEDICARE
NC
Enumeration date
08/31/2006
Last updated
12/11/2007
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