Individual
DR. LAURA M LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 CLEAVER FARM RD, SUITE 201, MIDDLETOWN, DE 19709-1630
(302) 633-6338
(302) 651-4945
Mailing address
PO BOX 191, PROVIDER ENROLLMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C1-000804.
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C1-0008043
PROFESSIONAL LICENSE
DE
Enumeration date
01/18/2007
Last updated
02/05/2013
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