Individual
DR. PETER OTTO LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
141 TUSCALOOSA ST, MOBILE, AL 36607-3422
(251) 433-3344
(251) 433-4052
Mailing address
PO BOX 7987, MOBILE, AL 36670-0987
(251) 633-0573
(251) 633-7367
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
24282
AL
207RP1001X
Pulmonary Disease Physician
Primary
24282
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051535063
MEDICARE
AL
01
—
09286019
MS MEDICAID
MS
05
—
212047
—
AL
05
—
212074
—
AL
05
—
220477
—
AL
05
—
221309
—
AL
01
—
2626772
UHC
AL
01
—
512-07156
BCBS
AL
01
—
512-07157
BCBS
AL
01
—
515-35061
BCBS
AL
01
—
588428
CIGNA HC
AL
01
—
7758434
AETNA
AL
05
—
9937486
—
AL
01
—
H92906
VIVA HEALTH
AL
01
—
P00319341
RR MEDICARE
AL
Enumeration date
07/01/2006
Last updated
06/21/2023
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