Individual
DAVID W LUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20050
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100251443-00
—
IA
05
—
3141721
—
IA
01
—
36902
WELLMARK BCBS IA
IA
05
—
7711450
—
IA
Enumeration date
05/05/2006
Last updated
09/28/2007
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