Healthcare Provider Details
I. General information
NPI: 1083668784
Provider Name (Legal Business Name): ST. LUKE'S HOSPITAL OF DULUTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 E 1ST ST STE 302
DULUTH MN
55805-2225
US
IV. Provider business mailing address
920 E 1ST ST STE 302
DULUTH MN
55805-2225
US
V. Phone/Fax
- Phone: 218-249-6050
- Fax:
- Phone: 218-249-6050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ERIC
LOHN
Title or Position: PRESIDENT, CEO
Credential:
Phone: 218-249-5475