Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lucas Tidwell, MD

Individual provider Surgery Physician · NPI 1942837588

Lucas Tidwell, MD is a Surgery Physician in Southfield, Michigan. Licensed in Michigan. Registered with an NPI since 2020.

Licensed in
MI
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

22250 Providence Dr Ste 206
Southfield, MI 48075-6210
Phone: (248) 662-4333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 4301514131 (MI)

Record details

NPI number1942837588
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2020
Last updated in NPPESJuly 8, 2025
Certification dateJuly 8, 2025

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