DR. STEPHENIE M LUCAS (NPI# 1023116068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023116068 |
Entity Type | Individual |
Full Name | DR. STEPHENIE M LUCAS |
Credential | M.D. |
Practice Address |
22631 Greater Mack Ave Suite 100 Saint Clair Shores MI 48080-2055 |
Mailing Address |
Po Box 44047 Detroit MI 48244-0047 |
Practice Telephone | 5867710100 |
Mailing Telephone | 2485840240 |
Mailing Fax Number | 2485840241 |
Enumeration Date | 2006-09-21 |
Last Update Date | 2010-06-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | SL032256 | MI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 2713258 | 05 |
Street Address |
22631 GREATER MACK AVE SUITE 100 |
City | SAINT CLAIR SHORES |
State | MI |
Zip Code | 48080-2055 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285654152 | Michael Allen Macdonald | Audiologist | 22631 Greater Mack Ave, Suite 100, Saint Clair Shores, MI 48080-2055 | 2006-07-20 |
1255886305 | Patricia Roach | Hearing Instrument Specialist | 22631 Greater Mack Ave, Ste 100, Saint Clair Shores, MI 48080-2055 | 2016-08-18 |
1538515721 | Audionet America - St Clair Shores LLC | Audiologist | 22631 Greater Mack Ave, Suite 100, Saint Clair Shores, MI 48080-2055 | 2016-05-06 |
1548597149 | Jo Anne Levitan Md PC | Surgery | 22631 Greater Mack Ave, Suite 300, Saint Clair Shores, MI 48080-2014 | 2009-11-03 |
1225217128 | Pointes Plastic Surgery Associates P C | Plastic Surgery | 22631 Greater Mack Ave, Suite 200, Saint Clair Shores, MI 48080-2055 | 2007-10-26 |
1255407631 | Joram O Mogaka | Internal Medicine | 22631 Greater Mack Ave, Saint Clair Shores, MI 48080-2055 | 2006-11-28 |
1982627196 | George Thomas Goffas | Oral & Maxillofacial Surgery | 22631 Greater Mack Ave, Ste 200, Saint Clair Shores, MI 48080-2055 | 2006-07-26 |
1144261272 | Joanne Levitan | Surgery | 22631 Greater Mack Ave, Suite 300, Saint Clair Shores, MI 48080-2014 | 2006-06-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
Find all providers in zip 48080 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
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Find all providers with the same taxonomy |
City | SAINT CLAIR SHORES |
Zip Code | 48080 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.