Individual
DR. WALTER R LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17075 PEARL ROAD, STRONGSVILLE, OH 44136
(440) 572-0422
Mailing address
17075 PEARL ROAD, STRONGSVILLE, OH 44136
(440) 572-0422
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
35 043762
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0414644
—
OH
Enumeration date
10/04/2006
Last updated
07/08/2007
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