Individual
MICHAEL SAMUEL LUCIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
16583
ND
2085R0202X
Diagnostic Radiology Physician
MD-46147
IA
Other
Enumeration date
06/18/2014
Last updated
08/14/2020
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