Individual
LUKAS JANTAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 FIELDS DR, SUITE A, SANFORD, NC 27330-5072
(919) 777-9005
(919) 708-1550
Mailing address
205 PAGE ROAD, PINEHURST, NC 28374-8798
(910) 295-5511
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
200400884
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145J1
BCBS NC
NC
01
—
199499
MEDCOST PROVIDER NUMBER
NC
05
—
5906881
—
NC
01
—
FH2967430
FIRSTCAROLINACARE #
NC
Enumeration date
04/18/2007
Last updated
01/23/2018
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