Provider Demographics
NPI:1083613061
Name:LU, GEORGE C (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
Last Name:LU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 NW BRIARCLIFF PKWY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1878
Mailing Address - Country:US
Mailing Address - Phone:816-541-2700
Mailing Address - Fax:
Practice Address - Street 1:1201 NW BRIARCLIFF PKWY
Practice Address - Street 2:SUITE 310
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1878
Practice Address - Country:US
Practice Address - Phone:816-541-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001011419207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2087310703Medicaid
MO205298813Medicaid
KS2087310703Medicaid
MO205298813Medicaid