Provider Demographics
NPI:1457724585
Name:LUTZ, CAITLIN MARTIN (PA)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:MARTIN
Last Name:LUTZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:410 MEADOW CREEK DR STE 205
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-9455
Mailing Address - Country:US
Mailing Address - Phone:301-829-4185
Mailing Address - Fax:301-829-4187
Practice Address - Street 1:410 MEADOW CREEK DR STE 205
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-9455
Practice Address - Country:US
Practice Address - Phone:301-829-4185
Practice Address - Fax:301-829-4187
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant