Individual
ROBERT G LUTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11125 DUNN RD, SUITE 204, SAINT LOUIS, MO 63136-6132
(314) 839-5522
(314) 839-5351
Mailing address
11125 DUNN RD, SUITE 204, SAINT LOUIS, MO 63136-6132
(314) 839-5522
(314) 839-5351
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036085097
IL
207RC0000X
Cardiovascular Disease Physician
Primary
101315
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360850972
—
IL
01
—
060065494
MORRMCR
—
01
—
060065495
ILRRMCR
IL
01
—
12857V3831
GHP/CMR
—
01
—
149885
MOBS/BLCHOICE
MO
01
—
177033
HLNK
—
05
—
205722705
—
MO
01
—
2500837
UHC
—
01
—
34842V8816
HCUSA
—
01
—
4243966
AETNA
—
01
—
5386951007
CIGNA
—
01
—
98151V30946
HLTHPART
—
01
—
F04428
MERCY
—
Enumeration date
08/25/2005
Last updated
03/28/2022
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