Basic Information
Provider Information
NPI: 1285605501
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LURIE
FirstName: MICHAEL
MiddleName: K
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 WILSON RD
Address2: SUITE 100
City: MONTEREY
State: CA
PostalCode: 93940
CountryCode: US
TelephoneNumber: 8316491000
FaxNumber:  
Practice Location
Address1: 2 UPPER RAGSDALE DR
Address2: B230
City: MONTEREY
State: CA
PostalCode: 939405736
CountryCode: US
TelephoneNumber: 8316490808
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/27/2006
LastUpdateDate: 05/11/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XG44637CAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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