Provider Demographics
NPI:1558575738
Name:LU, ROMMEL PERILLO (MD)
Entity Type:Individual
Prefix:
First Name:ROMMEL
Middle Name:PERILLO
Last Name:LU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:117 SUNNYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1827
Mailing Address - Country:US
Mailing Address - Phone:919-334-3900
Mailing Address - Fax:919-250-9280
Practice Address - Street 1:117 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1827
Practice Address - Country:US
Practice Address - Phone:193-343-9009
Practice Address - Fax:919-250-9280
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2021-04-02
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Provider Licenses
StateLicense IDTaxonomies
SC35337207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC353370Medicaid
NC5916231Medicaid
SCSC04328552OtherMEDICARE PTAN