MEDICARE: DR. WALTER DAVID LUCE 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	207R00000X	Internal Medicine Physician	26387	CO

General Provider Information

NPI Number	:	1679564918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER DAVID LUCE M.D.

Provider Business Mailing Address
First Line	:	11547 E 25TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80010-1273
Country	:	US
Telephone Number	:	303-444-5689
Fax Number	:	303-449-2933

Provider Business Practice Location Address
First Line	:	11547 E 25TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80010-1273
Country	:	US
Telephone Number	:	303-444-5689
Fax Number	:	303-449-2933

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

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	04/01/2021

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