Individual
SEAN R. LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1017 ASHES DR, SUITE 206, WILMINGTON, NC 28405-8308
(910) 239-9584
(910) 679-4086
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2007-01120
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023030459
—
NC
01
—
2071622
MEDICARE PTAN
NC
Enumeration date
07/24/2006
Last updated
10/30/2023
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