Provider Demographics
NPI:1043364532
Name:LUH, EDDY H (MD,)
Entity Type:Individual
Prefix:
First Name:EDDY
Middle Name:H
Last Name:LUH
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9811 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 2640
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-258-7788
Mailing Address - Fax:702-258-7787
Practice Address - Street 1:8930 W SUNSET RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5013
Practice Address - Country:US
Practice Address - Phone:702-258-7788
Practice Address - Fax:702-258-7787
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9681208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018390Medicaid
NVCC8463OtherANTHEM BLUE C & BLUE S
NVCC8463OtherANTHEM BLUE C & BLUE S
NVCC8463OtherANTHEM BLUE C & BLUE S
NVV39702Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NV450528902OtherTIN