MEDICARE: DR. ADAM JOSEPH LUBER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	55911	AZ

General Provider Information

NPI Number	:	1396155867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM JOSEPH LUBER M.D.

Provider Business Mailing Address
First Line	:	11130 N TATUM BLVD STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-1630
Country	:	US
Telephone Number	:	602-494-1817
Fax Number	:	602-494-7103

Provider Business Practice Location Address
First Line	:	11130 N TATUM BLVD STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-1630
Country	:	US
Telephone Number	:	602-494-1817
Fax Number	:	602-494-7103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2014
Last Update Date	:	02/02/2026

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