Provider Demographics
NPI:1720483373
Name:LUKE, ABIGAEL (MD)
Entity Type:Individual
Prefix:
First Name:ABIGAEL
Middle Name:
Last Name:LUKE
Suffix:
Gender:F
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:COBORN CANCER CENTER 1900 CENTRACARE CIRCLE
Mailing Address - Street 2:SUITE #1600
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-8021
Mailing Address - Country:US
Mailing Address - Phone:320-229-4900
Mailing Address - Fax:
Practice Address - Street 1:COBORN CANCER CENTER 1900 CENTRACARE CIRCLE SUITE #1600
Practice Address - Street 2:
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5630
Practice Address - Country:US
Practice Address - Phone:320-229-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN70101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program