Provider Demographics
NPI:1275810194
Name:LU, MICHAEL THE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:THE
Last Name:LU
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7951 NOLPARK CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5205
Mailing Address - Country:US
Mailing Address - Phone:410-969-2389
Mailing Address - Fax:410-969-2389
Practice Address - Street 1:7951 NOLPARK CT
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5205
Practice Address - Country:US
Practice Address - Phone:410-969-2389
Practice Address - Fax:410-969-2389
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20124183500000X
IL051294643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist