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Lucas M. Walden

Student in an Organized Health Care Education/Training Program

Student, Health Care

2500 Metrohealth Drive, Radiology Department, Cleveland, OH 44109

PECOS Enrollment

This provider is enrolled in PECOS as LUCAS WALDEN.

Based on the most recent information from CMS, provider Lucas M. Walden is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1124581988
Provider Type
Individual
Full Name
Walden, Lucas M.
Credential
M.D

Gender
Male
Sole Proprietor
No
Enumeration Date
4/9/2019
Last Updated
7/21/2021

Contact Information

Practice Location

2500 Metrohealth Drive, Radiology Department, Cleveland, OH 44109

(216) 778-7800

Unlisted Fax

Mailing Location

2500 Metrohealth Drive, Radiology Department, Cleveland, OH 44109

(216) 778-7800

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License 57-250450 Ohio

Lucas M. Walden

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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