Provider Demographics
NPI:1922105758
Name:LU, CALVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:
Last Name:LU
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 1:720 W LINCOLN HWY STE 720
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2547
Mailing Address - Country:US
Mailing Address - Phone:610-269-8415
Mailing Address - Fax:610-269-8419
Practice Address - Street 1:720 W LINCOLN HWY STE 720
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2547
Practice Address - Country:US
Practice Address - Phone:610-269-8415
Practice Address - Fax:610-269-8419
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026973E207R00000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010107270006Medicaid
PA0010107270006Medicaid
C33959Medicare UPIN