Individual
DR. STEPHENIE M LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22631 GREATER MACK AVE, SUITE 100, SAINT CLAIR SHORES, MI 48080-2055
(586) 771-0100
Mailing address
PO BOX 44047, DETROIT, MI 48244-0047
(248) 584-0240
(248) 584-0241
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
SL032256
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2713258
—
MI
Enumeration date
09/21/2006
Last updated
06/24/2010
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