Individual
MR. MICHAEL JOSEPH LUKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
790 NORTHERN BLVD, SUITE K, SOUTH ABINGTON TOWNSHIP, PA 18411-8799
(570) 586-4141
Mailing address
790 NORTHERN BLVD, SUITE K, SOUTH ABINGTON TOWNSHIP, PA 18411-8799
(570) 585-4141
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
OA002401
PA
363AS0400X
Surgical Physician Assistant
MA054092
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00975601
RR MEDICARE
—
Enumeration date
09/16/2009
Last updated
02/01/2012
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