Individual
JEREMY R. LUEDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 LEGACY PLZ W, LA PORTE, IN 46350-5296
(219) 379-3166
(219) 324-9730
Mailing address
400 LEGACY PLZ W, LA PORTE, IN 46350-5296
(219) 379-3166
(219) 324-9730
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01079264A
IN
208600000X
Surgery Physician
4301087609
MI
208600000X
Surgery Physician
57033-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07028
MEDICARE #
WI
05
—
300008363
—
IN
01
—
IN2920085
MEDICARE PTAN
IN
Enumeration date
05/14/2007
Last updated
03/17/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us