Individual
EVAN ANDREW LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 HEART DR, GREENVILLE, NC 27834-8982
(252) 744-1378
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2016-01389
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
2016-01389
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891133930
—
NC
01
—
19QNZ
BCBS
NC
01
—
NCY300A
MEDICARE
NC
Enumeration date
06/11/2013
Last updated
02/20/2024
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