Organization
STEPHEN LUCERO, MD, PC
Active
Organization
STEPHEN LUCERO, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN PAUL LUCERO MD (PRESIDENT)
(505) 989-8325
Entity
Organization
Contact information
Practice address
1650 HOSPITAL DR, SUITE 300, SANTA FE, NM 87505-4769
(505) 989-8325
(505) 982-7665
Mailing address
1650 HOSPITAL DR, SUITE 300, SANTA FE, NM 87505-4769
(505) 989-8325
(505) 982-7665
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
86 273
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37481
—
NM
01
—
NM 101791
GROUP PTAN
NM
01
—
NM 101792
INDIVIDUAL PTAN
NM
Enumeration date
02/07/2012
Last updated
04/13/2012
Update your record
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