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TREVOR ALDEN LUNDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4517 SOUTHLAKE PKWY, HOOVER, AL 35244-3280
(205) 985-4111
(205) 985-4326
Mailing address
4517 SOUTHLAKE PKWY, HOOVER, AL 35244-3280
(205) 985-4111
(205) 985-4326

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
23792
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009998935
AL
05
051529306
AL
01
51527709
BLUE CROSS/BLUE SHIELD
AL
01
51527723
BLUE CROSS/BLUE SHIELD
AL
01
51529306
BLUE CROSS BLUE SHIELD
AL
Enumeration date
04/07/2006
Last updated
10/23/2023
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