Individual
JOHN D LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5401 OLD COURT RD DEPT OF, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
(410) 496-7530
Mailing address
303 E NICOLLET BLVD, SUITE 330, BURNSVILLE, MN 55337
(952) 435-0177
(952) 435-6287
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
77877
MN
208600000X
Surgery Physician
Primary
D90135
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/22/2015
Last updated
08/05/2025
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