Individual
DR. THERESA MARIE LUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(541) 464-3519
Mailing address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
(541) 464-3519
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13681
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R103163
MEDICARE PART B
OR
Enumeration date
09/27/2006
Last updated
10/14/2010
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