Individual
DR. MICHAEL JOHN LUCA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-3149
Mailing address
CENTRALIZED CREDENTIALS & PRIVILEGING DIRECTORATE, 554 KEILY STREET, JACKSONVILLE, FL 32212-3049
(757) 953-7550
(757) 953-0090
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
0102203537
VA
390200000X
Student in an Organized Health Care Education/Training Program
L200550772430
FL
Other
Enumeration date
04/05/2012
Last updated
11/08/2021
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