Provider Demographics
NPI: | 1881783975 |
---|---|
Name: | EURE, LUTHER HAYEWOOD JR (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | LUTHER |
Middle Name: | HAYEWOOD |
Last Name: | EURE |
Suffix: | JR |
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: | 520 MAPLE AVE |
Mailing Address - Street 2: | SUITE C |
Mailing Address - City: | REIDSVILLE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27320-4652 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-342-6063 |
Mailing Address - Fax: | 336-342-7847 |
Practice Address - Street 1: | 520 MAPLE AVE |
Practice Address - Street 2: | SUITE C |
Practice Address - City: | REIDSVILLE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27320-4652 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-342-6063 |
Practice Address - Fax: | 336-342-6066 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-10-12 |
Last Update Date: | 2021-08-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 9300102 | 207V00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 30892 | Other | BCBS |
NCJ481A | Other | MEDICARE INDIVIDUAL PTAN LINKED TO FACULTY PRACTICE GROUP | |
NC | 1881783975 | Medicaid | |
NC | 1881783975 | Medicaid | |
NC | 30892 | Other | BCBS |