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Individual

JOHN HUME LUCAS IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5500 FRONT ST, SUITE 230, SUMMERVILLE, SC 29486-7735
(843) 569-1856
(843) 569-1879
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
20248
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00953718
RAIL ROAD MEDICARE
SC
05
T42406
SC
Enumeration date
07/11/2005
Last updated
07/21/2021
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