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NPI Code Detail

MEDICARE: MR. WILLIAM M LUCE CRNA

MEDICARE: MR. WILLIAM M LUCE CRNA
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
1367500000XCertified Registered Nurse Anesthetist49305SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992708614
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM M LUCE CRNA
Provider Business Mailing Address
First Line : 383 POINDEXTER LN
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-7859
Country : US
Telephone Number : 803-957-4907
Fax Number :
Provider Business Practice Location Address
First Line : 2720 SUNSET BLVD
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29169-4810
Country : US
Telephone Number : 803-791-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 11/09/2020

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