Individual
MATTHEW C LUNDIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1965 S FREMONT AVE, STE 220, SPRINGFIELD, MO 65804-2201
(417) 820-9055
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
2013017410
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053364281
—
MO
05
—
198935001
—
AR
05
—
200499740 A
—
OK
05
—
201077460A
—
KS
01
—
431560263
TRICARE
MO
01
—
P01208067
RR MCR
MO
Enumeration date
05/18/2006
Last updated
10/15/2013
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