MICHAEL SEAN LUEDEMAN MD NPI 1255592390

NPI Information

  • NPI: 1255592390
  • Provider Name: MICHAEL SEAN LUEDEMAN, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1505 W ELK AVE STE 2
    ELIZABETHTON, TN
    ZIP 37643
  • Phone: (423) 543-1261

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NPI Details

Michael Sean Luedeman, MD is a family medicine in Elizabethton, TN with 17 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Michael Sean Luedeman, MD NPI is 1255592390. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Graduation Year:2008

The provider's business location address is:

1505 W ELK AVE STE 2
ELIZABETHTON, TN
ZIP 37643-848
Phone: (423) 543-1261

The NPI 1255592390 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/20/2008 and was last updated on 6/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine14495NEVADANo
2207Q00000XFamily Medicine66943TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11255592390MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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