Provider Demographics
NPI:1801969472
Name:REGALADO, LUNINGNING V (MD)
Entity type:Individual
Prefix:DR
First Name:LUNINGNING
Middle Name:V
Last Name:REGALADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 VENOY RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1869
Mailing Address - Country:US
Mailing Address - Phone:734-728-2909
Mailing Address - Fax:734-728-3015
Practice Address - Street 1:4020 VENOY RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1869
Practice Address - Country:US
Practice Address - Phone:734-728-2909
Practice Address - Fax:734-728-3015
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI032298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI032298OtherSTATE LICENSE