Healthcare Provider Details

I. General information

NPI: 1104883180
Provider Name (Legal Business Name): ROBERT G LUKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 HIGHLAND AVE
CINCINNATI OH
45219-2333
US

IV. Provider business mailing address

2830 VICTORY PKWY STE 310
CINCINNATI OH
45206-3700
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-4061
  • Fax: 513-584-2599
Mailing address:
  • Phone: 513-245-3444
  • Fax: 513-245-3449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-056950
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35-056950
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: