Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. LUKE DAVID WIDSTROM, D.O.
ActiveDR. LUKE DAVID WIDSTROM, D.O. is a Sports Medicine healthcare provider located in DULUTH, Minnesota. NPI 1366886053 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · DULUTH, MN
Registration Details
- NPI Number
- 1366886053
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 24, 2013 (13.349132451495 yrs)
- Last Updated
- May 3, 2018
- Licenses
-
TL.0006261 (CO)58494 (MN)
Practice Information
- Address
-
400 EAST THIRD STREETESSENTIA HEALTH DULUTH CLINICDULUTH, MN, 558051951Browse MN providers · Browse ZIP 55805
- Phone
- 2187868364
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine
Other Sports Medicine Providers in DULUTH, MN
| Name | Credential | NPI |
|---|---|---|
| JANUS BUTCHER | — | 1588610992 |
| ANN CAROLINE SUDOH | — | 1730124678 |
| WADE ALAN LILLEGARD | — | 1497790547 |
| DANIEL LEE MARK | — | 1972539955 |
| DOUGLAS FREDERICK HOFFMAN | — | 1841228301 |
| KENJI SUDOH | — | 1619996832 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.