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Individual

LUDY LUKOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
407 EAST MAPLE STREET, SUITE 101, CUMMING, GA 30040
(770) 888-6697
(770) 888-6698
Mailing address
407 EAST MAPLE STREET, SUITE 101, CUMMING, GA 30040
(770) 888-6697
(770) 888-6698

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
070217
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003137069A
GA
Enumeration date
03/01/2009
Last updated
01/22/2014
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