Individual
TIMOTHY C LUKENBILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10571 TELEGRAPH RD STE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101272529
VA
208000000X
Pediatrics Physician
82764
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2016
Last updated
07/19/2021
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