Healthcare Provider Details

I. General information

NPI: 1225032089
Provider Name (Legal Business Name): DEBORAH MARIA LUCAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 06/03/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WG 'BILL' HEFNER VAMC 1601 BRENNER AVE
SALISBURY NC
28144
US

IV. Provider business mailing address

108 WAVERLY CIR
SALISBURY NC
28144-9419
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-9000
  • Fax:
Mailing address:
  • Phone: 704-639-9313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number9700366
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number9700366
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number9700366
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: