Individual
JONATHAN EVAN LUBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2800
Mailing address
555 E CHEVES ST, FLORENCE, SC 29506-2617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
89928
SC
208D00000X
General Practice Physician
89928
SC
Other
Enumeration date
03/21/2023
Last updated
10/28/2024
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