Individual
BERNARDO LUCENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12800 MISSISSIPPI ST, B201, CROWN POINT, IN 46307-6900
(219) 663-7000
(219) 663-8621
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7241
(317) 528-4252
(317) 865-8318
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01039302A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000721917
ANTHEM TRADITIONAL
IN
05
—
100354630
—
IN
Enumeration date
05/10/2006
Last updated
05/16/2012
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