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Individual

DR. DAVID J LUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
390 TOLL GATE RD, STE.200, WARWICK, RI 02886-4326
(401) 739-8010
(401) 739-6087
Mailing address
390 TOLL GATE RD, STE.200, WARWICK, RI 02886-4326
(401) 739-8010
(401) 739-6087

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
RI5902
RI
2086S0129X
Vascular Surgery Physician
MD05902
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003671
BLUE CHIP PROVIDER ID
RI
01
29066-9
BLUE CROSS PROVIDER ID
RI
05
7000782
RI
Enumeration date
07/19/2005
Last updated
11/23/2010
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