Provider Demographics
NPI:1699115014
Name:HYDER, LUKE AUGUSTE (MD)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:AUGUSTE
Last Name:HYDER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:LUKE
Other - Middle Name:AUGUSTE D'ANGEL
Other - Last Name:HYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:530 FONTAINE ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2019
Practice Address - Country:US
Practice Address - Phone:850-474-4775
Practice Address - Fax:850-484-8223
Is Sole Proprietor?:No
Enumeration Date:2013-06-29
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131034207ND0101X, 207ND0101X
FLME 131034207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology