Basic Information
| Provider Information | |||||||||
| NPI: | 1285676189 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUKE | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 CROSSROADS DR STE 306 | ||||||||
| Address2: | |||||||||
| City: | OWINGS MILLS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211175437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4437382889 | ||||||||
| FaxNumber: | 4344718540 | ||||||||
| Practice Location | |||||||||
| Address1: | 19841 N 27TH AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850274003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235826420 | ||||||||
| FaxNumber: | 6235826720 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 09/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | DR.0058099 | CO | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | ME 77687 | FL | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 62651 | AZ | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 46791 | 01 | FL | BCBS OF FL | OTHER | 7003004 | 01 | FL | AETNA | OTHER | 1193381 | 01 | FL | WELLCARE | OTHER | 256330400 | 05 | FL | MEDICAID | 9000162907 | 05 | CO | MEDICAID | 094385 | 05 | AZ | MEDICAID | 5095184 | 01 | FL | CIGNA | OTHER | 10G248 | 01 | FL | HEALTHY KIDS | OTHER | 280590 | 01 | FL | AVMED | OTHER | P303940 | 01 | FL | FREEDOM HEALTH | OTHER |