Provider Demographics
NPI:1790027654
Name:LU, PAUL MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MATTHEW
Last Name:LU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3701 MARKET ST
Mailing Address - Street 2:STE 640
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5508
Mailing Address - Country:US
Mailing Address - Phone:212-746-2942
Mailing Address - Fax:212-746-4610
Practice Address - Street 1:3701 MARKET ST
Practice Address - Street 2:STE 640
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5508
Practice Address - Country:US
Practice Address - Phone:212-746-2942
Practice Address - Fax:212-746-4610
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2016-12-05
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Provider Licenses
StateLicense IDTaxonomies
PAMD458374207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine