Provider Demographics
NPI:1578047239
Name:LUU, SHARON M (MGCS)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:M
Last Name:LUU
Suffix:
Gender:F
Credentials:MGCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 W. WALNUT ST.
Mailing Address - Street 2:IB 137B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-948-4363
Mailing Address - Fax:317-968-1354
Practice Address - Street 1:705 RILEY HOSPITAL DRIVE
Practice Address - Street 2:MSA3
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-948-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics