Provider Demographics
NPI:1386757706
Name:LUEPKE, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:LUEPKE
Suffix:
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 1:1201 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2339
Mailing Address - Country:US
Mailing Address - Phone:515-266-1000
Mailing Address - Fax:515-263-2220
Practice Address - Street 1:1201 PENN AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2339
Practice Address - Country:US
Practice Address - Phone:515-266-1000
Practice Address - Fax:515-263-2220
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24171207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3082685Medicaid
IA1386757706Medicaid
IA3082685Medicaid
IAI21268Medicare PIN
IAF26231Medicare UPIN
IAP00437284Medicare PIN