Provider Demographics
NPI:1336287994
Name:LU, MELVIN CHIA-HUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:CHIA-HUNG
Last Name:LU
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 1:10133 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-6385
Mailing Address - Country:US
Mailing Address - Phone:352-596-4401
Mailing Address - Fax:352-596-4431
Practice Address - Street 1:10133 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-6385
Practice Address - Country:US
Practice Address - Phone:352-596-4401
Practice Address - Fax:352-596-4431
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 70999207N00000X, 207ND0101X, 207ND0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
070012943OtherMEDICARE RAILROAD
38300AOtherBCBS GROUP NUMBER
31381OtherBCBS PROVIDER NUMBER
38300OtherBCBS GROUP NUMBER
CI5866OtherMEDICARE RAILROAD GRP #
38300OtherBCBS GROUP NUMBER
38300AOtherBCBS GROUP NUMBER
K0655AMedicare ID - Type Unspecified
CI5866OtherMEDICARE RAILROAD GRP #
K0655Medicare ID - Type Unspecified