Individual
BRYAN J LUNDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 MOUNT HOPE AVE, SUITE 210, BANGOR, ME 04401-5691
(207) 907-3030
(207) 907-3031
Mailing address
PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8941
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
016902
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00330360
RAILROAD MEDICARE
ME
01
—
SX4343
MEDICARE PTAN
ME
Enumeration date
06/10/2006
Last updated
02/15/2022
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