Individual
ALI MARIA LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-3353
Mailing address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-3353
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
4301097403
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26730
WELLMARK BCBS
IA
Enumeration date
07/30/2006
Last updated
11/18/2014
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