Individual
MICHAEL A LUTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3120 HIGHLAND RD, HERMITAGE, PA 16148-4512
(724) 342-2663
Mailing address
3120 HIGHLAND RD, HERMITAGE, PA 16148-4512
(724) 342-2663
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA0015631L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28474750800
BWC PROVIDER NUMBER
OH
Enumeration date
04/27/2006
Last updated
11/07/2007
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