Individual ProviderLucas M. WaldenStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address2500 Metrohealth Drive, Radiology Department, Cleveland, OH 44109(216) 778-7800PECOS EnrollmentThis 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 BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1124581988Provider TypeIndividualFull NameWalden, Lucas M.CredentialM.DGenderMaleSole ProprietorNoEnumeration Date4/9/2019Last Updated7/21/2021Contact InformationPractice LocationPractice Address2500 Metrohealth Drive, Radiology Department, Cleveland, OH 44109Phone(216) 778-7800FaxUnlisted FaxMailing LocationMailing Address2500 Metrohealth Drive, Radiology Department, Cleveland, OH 44109Phone(216) 778-7800FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense57-250450Ohio