Healthcare Provider Details

I. General information

NPI: 1144273707
Provider Name (Legal Business Name): MICHAEL ALUKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BODIN CIR
TRAVIS AFB CA
94535-1809
US

IV. Provider business mailing address

6315 ROCKHURST RD
BETHESDA MD
20817-1763
US

V. Phone/Fax

Practice location:
  • Phone: 707-631-9387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01061135A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: