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General NPI Number Information
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NPI Number | 1831457779
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Entity Type | Individual
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Provider Name | LUKE MCCRONE MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2012
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 560 W MITCHELL ST STE M40
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City | PETOSKEY
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State | MI
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Zip | 49770
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Country | US
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Telephone | 231-487-2391
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Fax | 231-487-6513
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Provider Business Mailing Address
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Address Line | 560 W MITCHELL ST STE M40
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City | PETOSKEY
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State | MI
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Zip | 49770-2278
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Country | US
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Telephone | 231-487-2391
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Fax | 231-487-6513
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301114164
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License Number State | MI
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