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NPI Code Detail

MEDICARE: CHRISTINA M LUCAS-VOUGIOUKLAKIS D.O.

MEDICARE: CHRISTINA M LUCAS-VOUGIOUKLAKIS D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician5101016920MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10H27501OTHERMIBLUE CROSS

General Provider Information

NPI Number : 1356559496
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA M LUCAS-VOUGIOUKLAKIS D.O.
Provider Business Mailing Address
First Line : 650 STEWART RD
Second Line :
City : MONROE
State : MI
Zip : 48162-4222
Country : US
Telephone Number : 734-240-4594
Fax Number :
Provider Business Practice Location Address
First Line : 650 STEWART RD
Second Line :
City : MONROE
State : MI
Zip : 48162-4222
Country : US
Telephone Number : 734-240-4594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 11/03/2023

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Directions to “ CHRISTINA M LUCAS-VOUGIOUKLAKIS D.O.” Practice Location

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