Provider Demographics
NPI:1033179122
Name:TRAN, LUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LUAN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LUAN
Other - Middle Name:V
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2245 GATEWAY ACCESS POINTE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-3078
Mailing Address - Country:US
Mailing Address - Phone:919-510-8900
Mailing Address - Fax:919-510-8977
Practice Address - Street 1:2245 GATEWAY ACCESS PT
Practice Address - Street 2:SUITE 315
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-3077
Practice Address - Country:US
Practice Address - Phone:919-510-8900
Practice Address - Fax:919-510-8977
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003013022086S0129X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1548206022OtherMEDICARE RAILROAD INDIVIDUAL PTAN
NCDE0112OtherGROUP MEDICARE RAILROAD PTAN
NC2323842OtherGROUP MEDICARE PTAN
G45985Medicare UPIN
NC2323842OtherGROUP MEDICARE PTAN