Individual
EDWARD MICHAEL LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18444 N 25TH AVE, STE 210, PHOENIX, AZ 85023-1264
(623) 537-5600
(866) 939-2673
Mailing address
18444 N 25TH AVE, STE 310, PHOENIX, AZ 85023-1266
(623) 537-5600
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
21440
AZ
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
21440
AZ
207XX0801X
Orthopaedic Trauma Physician
Primary
21440
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135378
—
AZ
Enumeration date
04/28/2006
Last updated
04/23/2014
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