Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 2901017877 | MI |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 71 | MD |
N | 204E00000X | Oral & Maxillofacial Surgeon | 4301083994 | MI |
Y | 204E00000X | Oral & Maxillofacial Surgeon | D64569 | MD |
N | 204E00000X | Oral & Maxillofacial Surgeon | MD29070 | OR |
N | 204E00000X | Oral & Maxillofacial Surgeon | MD431734 | PA |
NPI | 1134258817 |
---|---|
Provider Name | Dr. Joshua Eli Lubek |
First Address | Baltimore, MD 21201-1510 |
Second Address | Baltimore, MD 21201-1510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
286589 | (05) | OR |
R000WCKCG | MEDICARE PART B (01) | OR |