Provider Demographics
NPI:1568825552
Name:LYU, ANDREW CHI-TAI (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHI-TAI
Last Name:LYU
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 1:1600 EUCLID AVE APT 2808
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2157
Mailing Address - Country:US
Mailing Address - Phone:404-433-0503
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # M8-419
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA279280207R00000X
OH35.148071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine