Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 9800619 | NC |
Y | 207RH0003X | Hematology & Oncology | 9800619 | NC |
N | 207RX0202X | Medical Oncology | 9800619 | NC |
NPI | 1063402998 |
---|---|
Provider Name | Dr. Shantae Ladon Lucas |
First Address | Atlanta, GA 30368-7287 |
Second Address | Asheville, NC 28806-2316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2005 |
Last Update Date | 01/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1173A | BLUE CROSS BLUE SHIELD NC (01) | NC |
36-71291 | CIGNA (01) | NC |
36-71291 | UNITED HEALTHCARE (01) | NC |
830005265 | MEDICARE RAILROAD (01) | NC |
891173A | (05) | NC |
99564 | MEDCOST (01) | NC |
F84384 | (02) | NC |