Provider Demographics
NPI:1821213315
Name:JULIEN, LUCAS A (MD)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:A
Last Name:JULIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1627 LAKE LANSING RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3788
Mailing Address - Country:US
Mailing Address - Phone:517-372-0500
Mailing Address - Fax:517-482-3220
Practice Address - Street 1:1627 LAKE LANSING RD STE 100
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3788
Practice Address - Country:US
Practice Address - Phone:517-372-0500
Practice Address - Fax:517-482-3220
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301084048208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47053395014Medicaid
MIMI551001Medicare PIN
NE47053395014Medicaid