MEDICARE: LUKE THOMAS DILLON PA

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	363AS0400X	Surgical Physician Assistant	560100818	MI

General Provider Information

NPI Number	:	1669707170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE THOMAS DILLON PA

Provider Business Mailing Address
First Line	:	3100 CROSS CREEK PKWY STE 200
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-2776
Country	:	US
Telephone Number	:	248-377-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 CROSS CREEK PKWY STE 200
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-2776
Country	:	US
Telephone Number	:	248-377-8000
Fax Number	:	248-484-2129

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

Provider Enumeration Date	:	10/16/2009
Last Update Date	:	11/18/2024

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