Provider Demographics
NPI:1720281249
Name:LUK, JEFFREY HAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HAN
Last Name:LUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:BHC 5064
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-202-5446
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:BHC 5064
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-1636
Practice Address - Fax:216-844-7106
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038031207P00000X
MDD0069450207P00000X
NJ25MA08619500207P00000X
VA0101246179207P00000X
OH35.097370207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3156785Medicaid
OHP01013351OtherMEDICARE RAILROAD
OHH003000Medicare PIN