Individual
ALBERT LEE LUNDQUIST
Active
Individual
ALBERT LEE LUNDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
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
Update your record
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