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Individual

KARL J LUKETIC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3915 SUNFOREST CT, TOLEDO, OH 43623-4453
(419) 450-3337
Mailing address
3118 STONEGATE DR, MAUMEE, OH 43537-9423
(419) 450-3337

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35064065
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000127263
ANTHEM
01
0005908039
AETNA
05
0161435
OH
01
03297
PARAMOUNT
01
1451754
UNITED HEALTHCARE
01
180035529
RAILROAD MEDICARE
OH
Enumeration date
06/14/2005
Last updated
04/14/2015
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