Healthcare Provider Details

I. General information

NPI: 1871793471
Provider Name (Legal Business Name): DAVID ERIC LUKOWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2007
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3793 MCDOWELL LN STE 100
LITTLE RIVER SC
29566-7892
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-390-0100
  • Fax: 843-390-0038
Mailing address:
  • Phone: 843-390-0100
  • Fax: 843-390-0038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number33267
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number2009-01608
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number33267
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: