Provider Demographics
NPI:1336108414
Name:LALUK, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:LALUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 OAK VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-9413
Mailing Address - Country:US
Mailing Address - Phone:330-220-0809
Mailing Address - Fax:
Practice Address - Street 1:6681 RIDGE RD STE 308
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5705
Practice Address - Country:US
Practice Address - Phone:440-888-6304
Practice Address - Fax:440-888-6309
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-19
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.048686207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
393455OtherWELLCARE
4304866OtherAETNA
000000116599OtherANTHEM
000000116599OtherUNICARE
OH0515473Medicaid
0532663Medicare PIN
OH0515473Medicaid