Provider Demographics
NPI:1467833756
Name:LUCIS CONSULTING LLC
Entity Type:Organization
Organization Name:LUCIS CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:IBEANU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-565-2250
Mailing Address - Street 1:805 JENNINGS MILL DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-6214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:805 JENNINGS MILL DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-6214
Practice Address - Country:US
Practice Address - Phone:301-565-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty