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Individual

LUCAS TITUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
701 E ROSSER AVE, BISMARCK, ND 58501-4457
(701) 751-9500
(701) 751-9508
Mailing address
701 E ROSSER AVE, BISMARCK, ND 58501-4457
(701) 751-9500
(701) 751-9508

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RL16707
ND
208M00000X
Hospitalist Physician
Primary
20123
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1459002
ND
Enumeration date
07/01/2020
Last updated
02/01/2024
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