Provider Demographics
NPI:1215917331
Name:SPELLMAN, LUKE MICHAEL (DO)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:MICHAEL
Last Name:SPELLMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 A AVE NE STE 300
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5064
Mailing Address - Country:US
Mailing Address - Phone:319-368-9300
Mailing Address - Fax:319-368-5690
Practice Address - Street 1:855 A AVE NE STE 300
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5064
Practice Address - Country:US
Practice Address - Phone:319-368-9300
Practice Address - Fax:319-368-5690
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA38752080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine