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NPI Code Detail

MEDICARE: NATASHA FAYE LUCAS MD

MEDICARE: NATASHA FAYE LUCAS MD
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 PhysicianMT193776PA
2207QS0010XSports Medicine (Family Medicine) Physician25009WV
3207Q00000XFamily Medicine Physician0101270428VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831351436
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA FAYE LUCAS MD
Provider Business Mailing Address
First Line : PO BOX 9196
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-9196
Country : US
Telephone Number : 304-293-1164
Fax Number :
Provider Business Practice Location Address
First Line : 6040 UNIVERSITY TOWN CENTRE DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-2421
Country : US
Telephone Number : 304-293-6307
Fax Number : 304-293-1216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2008
Last Update Date : 10/30/2023

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