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General NPI Number Information
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NPI Number | 1013982891
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Entity Type | Individual
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Provider Name | SAM S LUK MD
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 17580 US HIGHWAY 441
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City | MOUNT DORA
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State | FL
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Zip | 32757-6711
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Country | US
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Telephone | 352-383-0608
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Fax |
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Provider Business Mailing Address
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Address Line | 3743 S ATLANTIC AVE #3C
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-7256
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Country | US
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Telephone | 386-767-7570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME 0066291
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License Number State | FL
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