Individual
DR. STEPHEN D LUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11123 PARKVIEW PLAZA DR STE 101, FORT WAYNE, IN 46845-1707
(260) 422-7455
(260) 422-4125
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01043704A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387845
ANTHEM
IN
05
—
200040440
—
IN
Enumeration date
06/02/2006
Last updated
10/03/2022
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