Individual
DR. LUNDY WADE COLVERT
Active
Individual
DR. LUNDY WADE COLVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036114113
IL
207P00000X
Emergency Medicine Physician
Primary
E-8137
AR
207R00000X
Internal Medicine Physician
E-8137
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00265156
RAILROAD MEDICARE
IL
Enumeration date
02/09/2007
Last updated
05/20/2021
Update your record
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