Individual
DR. JAMES D LUEDEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4463 STATE ROUTE 66, MINSTER, OH 45865-8727
(419) 628-3821
(419) 628-9501
Mailing address
200 SAINT CLAIR AVE, SAINT MARYS, OH 45885-2400
(419) 300-1129
(419) 394-9575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35048500L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105065
GROUP MEDICAID
OH
01
—
1184652539
GROUP NPI
OH
05
—
3012064
—
OH
01
—
34-1689161
JTDM FAMILY PRACTICE, LLC
OH
01
—
9934723
GROUP MEDICARE PTAN
OH
01
—
H319420
MEDICARE PTAN
OH
Enumeration date
10/11/2005
Last updated
02/22/2021
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