Individual
DONALD W. LUCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1309 10TH AVE W, MOBRIDGE, SD 57601-1146
(605) 845-8170
Mailing address
1309 10TH AVE W, MOBRIDGE, SD 57601-1146
(605) 845-8170
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4036
SD
208600000X
Surgery Physician
42530
MN
208600000X
Surgery Physician
51171
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020050950
MEDICARE - RAILROAD
MN
01
—
021M4LU
MNCARE
MN
01
—
021M4LU, 070L6LU
BCBS
MN
01
—
127977
MNCARE-U
MN
01
—
1700792, 3909161
MEDICA
MN
01
—
363606405
CHAMPUS
MN
05
—
611829100
—
MN
01
—
HP30630
HEALTH PARTNERS
MN
01
—
NA9501023797
PREFERRED ONE
MN
Enumeration date
12/14/2005
Last updated
01/28/2021
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