Provider Demographics
NPI:1669432613
Name:LUOMA, MICHAEL WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:LUOMA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:17TH MEDICAL GROUP
Mailing Address - Street 2:271 FT RICHARDSON AVENUE
Mailing Address - City:GOODFELLOW AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76908
Mailing Address - Country:US
Mailing Address - Phone:325-654-3141
Mailing Address - Fax:
Practice Address - Street 1:271 FT RICHARDSON AVENUE
Practice Address - Street 2:
Practice Address - City:GOODFELLOW AFB
Practice Address - State:TX
Practice Address - Zip Code:76908-2134
Practice Address - Country:US
Practice Address - Phone:325-654-3141
Practice Address - Fax:906-337-6582
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2022-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301081305207Q00000X
MI4301096299207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine