MICHAEL SAMUEL LUCIN


Address: 801 Broadway N, Fargo, ND 58102-3641
Phone: 7012342000

MICHAEL SAMUEL LUCIN (NPI# 1588078513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588078513
Entity Type Individual
Full Name MICHAEL SAMUEL LUCIN
Credential M.D.
Practice Address 801 Broadway N
Fargo
ND 58102-3641
Mailing Address Po Box 5074
Sioux Falls
SD 57117-5074
Practice Telephone 7012342000
Enumeration Date 2014-06-18
Last Update Date 2020-08-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
16583 ND Allopathic & Osteopathic Physicians
N 2085R0202X Radiology
Specialization: Diagnostic Radiology
MD-46147 IA Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
2101 Elm St N, Fargo, ND 581022417 8004109723
601 Highway 6 W, Iowa City, IA 522462209 3193380581

Office Location

Street Address 801 BROADWAY N
City FARGO
State ND
Zip Code 58102-3641

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528062924 Mark F Fisher Radiology 801 Broadway N, Fargo, ND 58102-3641 2005-06-13
1942809652 Morgan Margaret Borud Nurse Practitioner 801 Broadway N, Fargo, ND 58102-3641 2020-10-22
1790392462 Katie Thielges Nurse Practitioner 801 Broadway N, Fargo, ND 58102-3641 2020-09-28
1063022432 Lindsey Schmidt Genetic Counselor, MS 801 Broadway N, Fargo, ND 58102-3641 2020-07-31
1336766161 Yesha Shukla Family Medicine 801 Broadway N, Fargo, ND 58102-3641 2020-06-27
1891310850 Samantha Mimi Chang Family Medicine 801 Broadway N, Fargo, ND 58102-3641 2020-06-15
1528683224 Briana Lee Gebert-oberle Student in an Organized Health Care Education/Training Program 801 Broadway N, Fargo, ND 58102-3641 2020-06-09
1689296931 Jillian Virginia Schommer Student in an Organized Health Care Education/Training Program 801 Broadway N, Fargo, ND 58102-3641 2020-05-09
1194344036 Sarah Rose Carpenter Genetic Counselor, MS 801 Broadway N, Fargo, ND 58102-3641 2020-04-10
1346871258 Randall Hagemeister Nurse Anesthetist, Certified Registered 801 Broadway N, Fargo, ND 58102-3641 2020-01-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780285924 Shelley Dene Townsend-hansen Dentist 1017 Broadway N, Fargo, ND 58102 2020-11-04
1275190779 Anthony Joseph Duncan Student in an Organized Health Care Education/Training Program 1919 Elm Streent North, Fargo, ND 58102 2019-05-21
1003472317 Sadie Marie Nelson Nurse Practitioner Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 2019-05-13
1124523576 Christopher Peroutka Specialist/Technologist 1300 17th Ave N, Fargo, ND 58102 2018-03-28
1205331873 Nathan Koens Specialist/Technologist 1300 17th Avenue North, Fargo, ND 58102 2018-03-27
1376063370 Abby Nicole Fredrickson Student in an Organized Health Care Education/Training Program 1919 Elm Street North, Fargo, ND 58102 2017-06-21
1780118331 Stephanie Melquist Internal Medicine Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 2017-04-19
1104215623 Justin Lervik Social Worker 211 Elm St. N, 122, Fargo, ND 58102 2015-01-21
1770919441 Courtney Ann Simanski Speech-Language Pathologist 415 4th St. N., Fargo, ND 58102 2013-09-25
1821431206 Lanell Staroba Pharmacist 706 D 38th St, Fargo, ND 58102 2013-04-16
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346267812 Francisco V Ouano Radiology 2907 32nd St S, Fargo, ND 58103-7863 2006-07-17
1114942372 Kathleen Ann Wood Radiology 705 13th Ave N, Apt. 310, Fargo, ND 58102-2680 2006-07-12
1649251224 Martha Slade Kearns Radiology 23 Briarwood Pl, Fargo, ND 58104-7308 2005-11-09
1528062924 Mark F Fisher Radiology 801 Broadway N, Fargo, ND 58102-3641 2005-06-13
1447661285 Tarik Nurkic Radiology 5225 23rd Ave S, Fargo, ND 58104-7927 2014-05-14
1528328754 Matthias M Albin Radiology 3000 32nd Ave S, Fargo, ND 58103 2012-05-22
1437418993 Safia Hope Cheeney Radiology 801 Broadway N, Fargo, ND 58102-3641 2012-05-03
1922396993 Adam F Stibbe Radiology 3000 32nd Ave S, Fargo, ND 58103-6132 2011-07-12
1568754521 Aaron Richard Jones Radiology 3000 32nd Ave S, Department of Radiology, Essentia Health, Fargo, ND 58103-6132 2011-05-10
1881985182 Thomas Philip Kennedy Radiology 801 Broadway N, Fargo, ND 58102-3641 2011-04-21
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Competitor

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City FARGO
Zip Code 58102

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Dataset Information

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.

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