Provider Demographics
NPI:1407820483
Name:MARONE, LUKE KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:KEITH
Last Name:MARONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:ATTN PROVIDER ENROLLMENT
Mailing Address - City:DUBOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:724-986-0698
Mailing Address - Fax:814-372-2676
Practice Address - Street 1:1029 COUNTRY CLUB RD STE 204
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1564
Practice Address - Country:US
Practice Address - Phone:724-997-3470
Practice Address - Fax:724-997-3471
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422385174400000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100821731Medicaid
PA100821731Medicaid
PAH51107Medicare UPIN