Individual
EDWARD R LUTKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 983-8300
Mailing address
2000 GREEN RD, SUITE 300, ANN ARBOR, MI 48105-1598
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
048231
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2585069
—
MI
05
—
3047753
—
MI
05
—
3404097
—
MI
05
—
4700212
—
MI
05
—
4700240
—
MI
01
—
EL048231
BC/BS
MI
Enumeration date
06/17/2006
Last updated
06/05/2008
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