Individual
KEVIN LU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2360 MARYLAND RD, WILLOW GROVE, PA 19090-1709
(215) 657-6776
(267) 913-5963
Mailing address
2360 MARYLAND RD, WILLOW GROVE, PA 19090-1709
(215) 657-6776
(267) 913-5963
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD474758
PA
207R00000X
Internal Medicine Physician
MT210708
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD474758
MD LICENSE
PA
Enumeration date
06/16/2016
Last updated
08/11/2021
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