Provider Demographics
NPI:1659891851
Name:LU, KUO JUNG GORDON (MD)
Entity type:Individual
Prefix:
First Name:KUO JUNG
Middle Name:GORDON
Last Name:LU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:MASSACHUSETTS GENERAL HOSPITAL
Mailing Address - Street 2:55 FRUIT ST.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-2800
Mailing Address - Fax:
Practice Address - Street 1:13285 MINNIEVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4018
Practice Address - Country:US
Practice Address - Phone:703-986-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2025-05-19
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Provider Licenses
StateLicense IDTaxonomies
VA0101275179208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology