Provider Demographics
NPI:1912573809
Name:LU, MIN (ACU)
Entity Type:Individual
Prefix:
First Name:MIN
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:ACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 QUINCE ORCHARD RD STE 280
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1437
Mailing Address - Country:US
Mailing Address - Phone:757-739-9892
Mailing Address - Fax:
Practice Address - Street 1:555 QUINCE ORCHARD RD STE 280
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1437
Practice Address - Country:US
Practice Address - Phone:757-739-9892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02806171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty