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Search › Michigan › 261QP2000X

Sony Lukose

NPI 1174028781 · on the registry since 2018 · sole proprietor

Practice

Address
21401 Mack Ave
Grosse Pointe Woods, MI 48236
Phone
(586) 778-0800
Organisation at this address
Optalis Grosse Pointe Opco Llc
Heartland - Georgian East Of Grosse Point Mi, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
14

Registry record

Primary taxonomy
261QP2000X
261QP2000X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-03-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan