Individual
DR. MARK LUNDBLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
7205 LITTLE RIVER TPKE, ANNANDALE, VA 22003-3304
(703) 256-4030
Mailing address
4108 FOUNTAINSIDE LN, FAIRFAX, VA 22030-6097
(703) 994-6429
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202205245
VA
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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