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Individual

STEPHEN LU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2ND AMBULATORY CARE CTR, 2211 LOMAS BLVD. NE, ALBUQUERQUE, NM 87131-0001
(505) 272-2336
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01081657A
IN
208600000X
Surgery Physician
2000-233
NM
2086S0102X
Surgical Critical Care Physician
01081657A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001250433
ANTHEM PTAN
IN
05
300022420
IN
Enumeration date
08/02/2006
Last updated
02/17/2025
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