Provider Demographics
NPI:1629316914
Name:CORPUZ, VIKTOR LUCAS (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKTOR
Middle Name:LUCAS
Last Name:CORPUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:175 EAST CHESTER PIKE
Mailing Address - Street 2:HAN INTERNAL MEDICINE
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-2212
Mailing Address - Country:US
Mailing Address - Phone:610-595-6586
Mailing Address - Fax:610-595-6787
Practice Address - Street 1:450 CHEW ST
Practice Address - Street 2:SIGAL CENTER
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3434
Practice Address - Country:US
Practice Address - Phone:610-776-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455308207Q00000X, 208M00000X
NY284502208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine