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Individual

BAOTRAM NGOC LUU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, MPAS

Contact information

Practice address
ONE MEDICAL CENTER BLVD, SUITE 404, UPLAND, PA 19013
(610) 619-8590
(610) 619-8591
Mailing address
ONE MEDICAL CENTER BLVD, SUITE 404, UPLAND, PA 19013
(610) 619-8590
(610) 619-8591

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA051657
PA
363AM0700X
Medical Physician Assistant
Primary
MA051657
PA

Other

Enumeration date
06/26/2014
Last updated
07/01/2014
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