Individual
DAN WILLIAM LUEDKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1475 KISKER RD, SUITE 180, ST CHARLES, MO 63304
(636) 442-7300
(636) 442-7398
Mailing address
500 MEDICAL DRIVE, WENTZVILLE, MO 63385
(636) 327-1202
(636) 327-1222
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
D8330
TX
207RH0003X
Hematology & Oncology Physician
Primary
R8512
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117860
HEALTHLINK
—
05
—
202356127
—
MO
01
—
21630
BCBS
MO
01
—
3600031
UHC
—
01
—
4037806
AETNA
—
01
—
43616
GHP
—
01
—
830001889
RR MEDICARE
—
Enumeration date
04/06/2006
Last updated
09/10/2012
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