Individual
KEITH G LURIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303
(320) 252-5131
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303
(320) 252-5131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35059
MN
207RC0000X
Cardiovascular Disease Physician
35059
MN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35059
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100317
U CARE
—
01
—
1009220
PREFERRED ONE
—
01
—
179582100
MEDICAL ASSISTANCE
—
05
—
179582100
—
MN
01
—
2500171
MEDICA HEALTH PLANS
—
01
—
768237
ARAZ GROUP AMERICAS PPO
—
01
—
77D97LU
BLUE CROSS BLUE SHIELD
—
01
—
HP22045
HEALTH PARTNERS
—
Enumeration date
08/11/2005
Last updated
05/21/2010
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