Provider Demographics
NPI:1558464982
Name:ARTACHE, LUIS ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ENRIQUE
Last Name:ARTACHE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:STREET # SALMON ESTANCIAS DE MANATI
Mailing Address - Street 2:BUZON 128 C-14
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0000
Mailing Address - Country:US
Mailing Address - Phone:788-531-7938
Mailing Address - Fax:787-740-8783
Practice Address - Street 1:ANDREAS COURT
Practice Address - Street 2:370 STREET 10 APT. 156 H-6
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-0097
Practice Address - Country:US
Practice Address - Phone:787-531-7938
Practice Address - Fax:787-740-8787
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13873208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH98073Medicare UPIN
PR2-2117Medicare ID - Type UnspecifiedGENERAL MEDICINE