Provider Demographics
NPI:1437115870
Name:LUTAS, ANEMARIA (MD)
Entity type:Individual
Prefix:DR
First Name:ANEMARIA
Middle Name:
Last Name:LUTAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OAK FOREST RD STE C
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4974
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 OAK FOREST RD STE C
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4974
Practice Address - Country:US
Practice Address - Phone:843-815-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC38719207R00000X, 207R00000X
IN01055289A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200399450Medicaid
IN0000007894044OtherANTHEM BLUE CROSS/BLUE SHIELD PIN
ILH75098Medicare UPIN
IN0000007894044OtherANTHEM BLUE CROSS/BLUE SHIELD PIN
INH75098Medicare UPIN