Individual
MICHAEL ANGELO LUCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4801 BECKNER RD, SANTA FE, NM 87507-3641
(505) 772-2000
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
9178
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016741
—
NV
Enumeration date
09/28/2006
Last updated
01/14/2020
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