Provider Demographics
NPI:1679537468
Name:LUKL, PETER (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:LUKL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:115 LINCOLN ST
Mailing Address - Street 2:METROWEST MEDICAL CENTER
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6358
Mailing Address - Country:US
Mailing Address - Phone:508-383-1091
Mailing Address - Fax:508-820-9654
Practice Address - Street 1:115 LINCOLN ST
Practice Address - Street 2:METROWEST MEDICAL CENTER
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6358
Practice Address - Country:US
Practice Address - Phone:508-383-1091
Practice Address - Fax:508-820-9654
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA34713207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3008037Medicaid
MA3008037Medicaid
MAE36279Medicare UPIN