Provider Demographics
NPI:1275642308
Name:ALICEA GARCIA, LUZ V (MD)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:V
Last Name:ALICEA GARCIA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:60 DON QUIXOTE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-6034
Mailing Address - Country:US
Mailing Address - Phone:787-378-5842
Mailing Address - Fax:
Practice Address - Street 1:510 BUTLER AVE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-9991
Practice Address - Country:US
Practice Address - Phone:304-263-0811
Practice Address - Fax:304-262-1418
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
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PE3764OtherPAN AMERICAN LIFE INS
212125OtherPREFERRED HEALTH PLAN
G65130Medicare UPIN