Provider Demographics
NPI:1871571752
Name:LUNA, JOSEPH B (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 253
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-0253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1510 S STATE RD
Practice Address - Street 2:SUITE A
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1965
Practice Address - Country:US
Practice Address - Phone:810-658-8343
Practice Address - Fax:810-658-3743
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068184208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI139950OtherCARE CHOICES
MI201571567OtherHEALLTH NET FEDERAL SERVI
MI3502511391OtherBLUE CARE NETWORK
MI1012600OtherMCLAREN HEALTH PLAN
MI104670463Medicaid
MI0984977OtherGENESEE COUNTY HEALTH PLA
MI0984977OtherHEALTHPLUS MEDICAID
MI1012600OtherMCLAREN HEALTH ADVANTAGE
MI139950OtherPREFERRED CHOICES
MI7607664OtherAETNA
MIG97184OtherHAP PREFERRED PPO
MI201571567OtherPPOM
MI2281218OtherFIRST HEALTH NETWORK
MI3502511391OtherFEP BLUE CROSS BLUE SHIEL
MIG97184OtherHEALTH ALLIANCE PLAN
MI0984977OtherHEALTHPLUS
MI725-1OtherTOTAL HEALTH CARE
MIC6592OtherMCARE
MI725-1OtherTOTAL HEALTH CARE
MI0984977OtherHEALTHPLUS MEDICAID