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General NPI Number Information
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NPI Number | 1386634830
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Entity Type | Individual
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Provider Name | STEPHEN C LUCK MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE 1133 21ST STR., NW, SUITE 1000
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City | WASHINGTON, DC
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State | DC
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Zip | 20036
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Country | US
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Telephone | 202-416-2145
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Fax | 202-223-9047
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Provider Business Mailing Address
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Address Line | MEDSTAR SURGERY CENTER @ LAFAYETTE CENTRE 1133 21ST STR., NW, SUITE 1000
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City | WASHINGTON
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State | DC
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Zip | 20036
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Country | US
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Telephone | 202-416-2145
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Fax | 202-416-2108
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101053390
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | D57523
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD20762
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License Number State | DC
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