Provider Demographics
NPI:1780970772
Name:LUCAR, JOSE ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:LUCAR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:ANTONIO
Other - Last Name:LUCAR LLOVERAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2150 PENNSYLVANIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-2323
Mailing Address - Fax:202-741-2324
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-2323
Practice Address - Fax:202-741-2324
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD042363207RI0200X
MS24276207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP01713163OtherRAILROAD MEDICARE PTAN
MS08059069Medicaid
MS08059069Medicaid