Individual
ANDREW LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5601007974
MI
363AS0400X
Surgical Physician Assistant
Primary
5601007974
MI
Other
Enumeration date
11/10/2016
Last updated
04/09/2021
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