Provider Demographics
NPI:1184626368
Name:LUGO, ANTHONY F (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:F
Last Name:LUGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2912 SPRINGBORO W
Mailing Address - Street 2:STE 201
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1674
Mailing Address - Country:US
Mailing Address - Phone:937-436-0300
Mailing Address - Fax:937-438-4694
Practice Address - Street 1:1989 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3859
Practice Address - Country:US
Practice Address - Phone:937-436-0300
Practice Address - Fax:937-438-4694
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-05-29
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Provider Licenses
StateLicense IDTaxonomies
OH35036236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2361822Medicaid
OH421534506033OtherCARESOURCE
OH996267OtherAETNA
OH000000227892OtherUNICARE
OH0120511OtherUNITED HEALTHCARE
OHOC04291OtherNATIONWIDE HEALTH PLAN
OH000000227892OtherANTHEM
OH080189849OtherRAILROAD MEDICARE
OH35036236LOtherMEDICAL LICENSE
OHD3623604OtherHUMANA/CHOICECARE
OHLU0398803Medicare PIN
OHOC04291OtherNATIONWIDE HEALTH PLAN