Individual
ALBERT LEE LUNDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
3312 BATTLEGROUND AVE, GREENSBORO, NC 27410-2402
(336) 282-5000
(336) 545-9792
Mailing address
PO BOX 38157, GREENSBORO, NC 27438-8157
(336) 282-5000
(336) 545-9792
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0110840384
VA
207W00000X
Ophthalmology Physician
Primary
100986
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
561783008
TAX ID
NC
Enumeration date
08/22/2005
Last updated
02/04/2011
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