Individual
MARY ELLEN JOAN LUCHETTI
Active
Individual
MARY ELLEN JOAN LUCHETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
28963
AZ
207N00000X
Dermatology Physician
044009
GA
207N00000X
Dermatology Physician
103253
MT
207N00000X
Dermatology Physician
G65392
CA
207N00000X
Dermatology Physician
Primary
MD2006-0021
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137516
—
GA
Enumeration date
08/22/2005
Last updated
09/17/2024
Update your record
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