Provider Demographics
NPI:1124439013
Name:LUKE, ELIZABETH WAUD (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:WAUD
Last Name:LUKE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3300 CAHABA RD
Mailing Address - Street 2:STE 102
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2629
Mailing Address - Country:US
Mailing Address - Phone:205-870-7292
Mailing Address - Fax:205-638-9996
Practice Address - Street 1:3300 CAHABA RD
Practice Address - Street 2:STE 102
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2629
Practice Address - Country:US
Practice Address - Phone:205-870-7292
Practice Address - Fax:205-638-9996
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2020-02-03
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Provider Licenses
StateLicense IDTaxonomies
ALMD36928208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL214929Medicaid