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General NPI Number Information
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NPI Number | 1699776351
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Entity Type | Individual
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Provider Name | PETER JOSEPH LUKOWSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 10/16/2015
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Provider Practice Location Address
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Address Line | 3980 HIGHWAY 9 E SUITE 200
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City | LITTLE RIVER
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State | SC
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Zip | 29566-8163
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Country | US
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Telephone | 843-390-0100
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Fax | 843-390-0038
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Provider Business Mailing Address
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Address Line | PO BOX 3239
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City | FLORENCE
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State | SC
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Zip | 29502-3239
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Country | US
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Telephone | 843-777-7162
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Fax | 843-777-7102
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 11728
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 200200401
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License Number State | NC
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