Wibowo, Luke
Wibowo, Luke is an individual health care provider with primary practice located at 1 Wyoming St , Dayton OH 45409-2722. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Wibowo, Luke can be contacted via phone (937) 208-2978.Contact Information
Primary practice address
1 Wyoming St
Dayton OH 45409-2722
Phone: (937) 208-2978
Fax: (937) 208-6137
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 35.068054 | Ohio |
Profile Details
| NPI number | 1861487068 |
|---|---|
| LBN Legal business name | Wibowo, Luke |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2005 |
| Last updated | Jan 27th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861487068 | NPPES |
| Ohio | MEDICAID | 0338469 |
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