Provider Demographics
NPI:1275598971
Name:LUGINBILL, DAVID WARREN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WARREN
Last Name:LUGINBILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1200 E MICHIGAN AVE
Mailing Address - Street 2:SUITE 325
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1800
Mailing Address - Country:US
Mailing Address - Phone:517-364-5160
Mailing Address - Fax:517-364-5165
Practice Address - Street 1:1200 E MICHIGAN AVE
Practice Address - Street 2:SUITE 325
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1800
Practice Address - Country:US
Practice Address - Phone:517-364-5160
Practice Address - Fax:517-364-5165
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101007533207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3477262Medicaid
MI01-5-33-3728-4OtherBCBS INDIVIDUAL PIN NUMBE
MI3477262Medicaid