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Individual

JOHN P LUNDEBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
608 NORTHWEST BLVD, SUITE 301, COEUR D ALENE, ID 83814-2174
(208) 664-4940
(208) 664-5345
Mailing address
608 NORTHWEST BLVD, SUITE 301, COEUR D ALENE, ID 83814-2174
(208) 664-4940
(208) 664-5345

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M6914
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807104000
ID
Enumeration date
08/31/2006
Last updated
07/08/2007
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