Provider Demographics
NPI:1841372869
Name:LU, FEI (MD)
Entity type:Individual
Prefix:
First Name:FEI
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 CEDAR ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-2057
Mailing Address - Country:US
Mailing Address - Phone:574-335-8700
Mailing Address - Fax:574-335-0760
Practice Address - Street 1:611 E DOUGLAS RD STE 208
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545
Practice Address - Country:US
Practice Address - Phone:574-335-6700
Practice Address - Fax:574-335-0726
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI102309207RC0001X
IN01078414A207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000001163780OtherBCBS
IN300002725Medicaid
ININ1041057OtherMEDICARE
MN1032273OtherPREFERRED ONE
MT0081923Medicaid
MN25-00021OtherMEDICA-PRIMARY
MN25-00806OtherMEDICA-CHOICE
MN518449OtherFAIRVIEW
MNHP37435OtherHEALTH PARTNERS