Provider Demographics
NPI:1780639880
Name:LUEA, PETER J (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:LUEA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:STE 202
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3820
Mailing Address - Fax:517-913-3821
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:STE 202
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-3820
Practice Address - Fax:517-913-3821
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2009-10-08
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Provider Licenses
StateLicense IDTaxonomies
MI4301073005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0803312661OtherBLUE CROSS BLUE SHIELD/BLUE CARE NETWORK
MI080172079OtherRAILROAD MEDICARE
MI0M21440020OtherMEDICARE ADVANTAGE
MI1002583OtherMCLAREN HEALTH ADVANTAGE
MI200000002324OtherPHP
MI200000002324OtherPHP FAMILYCARE
MI7172277OtherAETNA
MI1002583OtherMCLAREN HEALTH PLAN-MEDICAID
MI1002583OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI4308068Medicaid
MI200000002324OtherPHP FAMILYCARE
MI0M21440020OtherMEDICARE ADVANTAGE