Doctor Name: | JOHN T LUNDQUIST |
NPI Number: | 1972708980 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | C.PED. |
License Number: | |
Business Practice Address: | 2419 Lewisville Clemmons Rd Suite 1 Clemmons, NC - 270128976 |
Business Phone Number: | 3367124750 |
Business Fax Number: | 3367121056 |
Mailing Address: | 2419 Lewisville Clemmons Rd, Suite 1 CLEMMONS |
State: | NC |
Postal Code: | 270128976 |
Phone Number: | 3367124750 |
Fax Number: | 3367121056 |
NPI Enumeration Date: | 06/19/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |