Provider Demographics
NPI:1902986698
Name:LU, CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7900 COBBLESTONE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4328
Mailing Address - Country:US
Mailing Address - Phone:651-338-9402
Mailing Address - Fax:
Practice Address - Street 1:3100 KENNARD ST
Practice Address - Street 2:STE 100
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5465
Practice Address - Country:US
Practice Address - Phone:651-232-7800
Practice Address - Fax:651-232-7940
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN45782207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist