Individual
MICHAEL SEAN LUEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1505 W ELK AVE STE 2, ELIZABETHTON, TN 37643-2848
(423) 543-1261
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14495
NV
207Q00000X
Family Medicine Physician
Primary
66943
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255592390
—
NV
Enumeration date
06/20/2008
Last updated
06/10/2024
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