Provider Demographics
NPI:1790957686
Name:NADEN, LUCAS (LAC, MAC, DIPLAC)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:
Last Name:NADEN
Suffix:
Gender:M
Credentials:LAC, MAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7856 FOXFARM LN
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8131 GOV RITCHIE HWY
Practice Address - Street 2:SUITE K
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-6940
Practice Address - Country:US
Practice Address - Phone:410-218-1162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01645171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist