Individual
GEORGE W. LUEDKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1049 CLAYMONT DR, LYNCHBURG, VA 24502-4481
(434) 582-1600
(434) 582-4807
Mailing address
1048 TERRACE DR, MARION, VA 24354-4138
(276) 783-1827
(276) 783-2879
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
0101031815
VA
2084F0202X
Forensic Psychiatry Physician
0101031815
VA
2084P0800X
Psychiatry Physician
Primary
0101031815
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001238
VALUE OPTIONS PROVIDER NU
—
05
—
010220751
—
VA
01
—
186467
ANTHEM PROVIDER NUMBER
—
01
—
20-3639329
PCHP PROVIDER NUMBER
—
01
—
203639329001
TRICARE PROVIDER NUMBER
—
01
—
70985
CIGNA BEHAVIOR PROVIDER N
—
01
—
84228M
SENTARA/OPTIMA PROVIDER N
—
Enumeration date
09/09/2005
Last updated
04/30/2018
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