Provider Demographics
NPI:1760421309
Name:LUTES, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:LUTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:830 SW MULVANE ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1654
Mailing Address - Country:US
Mailing Address - Phone:785-270-8625
Mailing Address - Fax:785-270-8624
Practice Address - Street 1:830 SW MULVANE ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1654
Practice Address - Country:US
Practice Address - Phone:785-270-8625
Practice Address - Fax:785-270-8624
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-26912208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS067337OtherMEDICARE PTAN
KS100288280BMedicaid
KS067337OtherMEDICARE PTAN