Provider Demographics
NPI:1609944578
Name:JOSEPH B. LUNA M.D., P.C.
Entity Type:Organization
Organization Name:JOSEPH B. LUNA M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-658-8343
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-0253
Mailing Address - Country:US
Mailing Address - Phone:810-658-8343
Mailing Address - Fax:810-658-3743
Practice Address - Street 1:1510 S STATE RD
Practice Address - Street 2:SUITE A
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1965
Practice Address - Country:US
Practice Address - Phone:810-658-8343
Practice Address - Fax:810-658-3743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068184208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0984977OtherHEALTHPLUS
MI3502511391OtherBCBS
MI10 4670463Medicaid
MI0984977Medicaid
MI139950OtherPREFERRED CHOICES
MI139950OtherCARE CHOICES
MI3502511391OtherBCN
MI725-1Medicaid
MIG97184OtherHAP
MI1012600OtherMCLAREN HEALTH ADVANTAGE
MI7607664OtherAETNA
MI1012600Medicaid
MI2281218OtherFIRST HEALTH NETWORK
MIMCAREOtherC6592
MI=========OtherPPOM
MI1012600Medicaid
MI7607664OtherAETNA
MIMI 4821001Medicare PIN