Doctor Name: | DEBORAH A LUETZOW |
NPI Number: | 1285688713 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 29691 |
Business Practice Address: | 2413 W Rawson Ave Oak Creek, WI - 531541323 |
Business Phone Number: | 4143330064 |
Business Fax Number: | |
Mailing Address: | 2413 W. Rawson Ave, OAK CREEK |
State: | WI |
Postal Code: | 53154 |
Phone Number: | 4143330064 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2006 |
NPI Last Update Date: | 12/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | 29691 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |