Provider Demographics
NPI:1306004270
Name:CUERVO, LUIS JAIME (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:JAIME
Last Name:CUERVO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3500 ARENDELL ST
Mailing Address - Street 2:PO DRAWER 1619
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2901
Mailing Address - Country:US
Mailing Address - Phone:252-808-6177
Mailing Address - Fax:252-808-6637
Practice Address - Street 1:3500 ARENDELL ST
Practice Address - Street 2:PO DRAWER 1619
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2901
Practice Address - Country:US
Practice Address - Phone:252-808-6177
Practice Address - Fax:252-808-6637
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2013-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN3585207R00000X
NC2012-01277207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine