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NPI Code Detail

MEDICARE: LUKE CORDER

MEDICARE: LUKE CORDER
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
1367500000XCertified Registered Nurse Anesthetist4704355641MI

General Provider Information

NPI Number : 1720825326
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKE CORDER
Provider Business Mailing Address
First Line : 1860 MOORHOUSE ST
Second Line :
City : FERNDALE
State : MI
Zip : 48220-1195
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1860 MOORHOUSE ST
Second Line :
City : FERNDALE
State : MI
Zip : 48220-1195
Country : US
Telephone Number : 517-614-6017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2024
Last Update Date : 12/15/2025

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Directions to “ LUKE CORDER ” Practice Location

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