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Individual

DONALD WAYNE LUNDIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
919 S CHURCH ST, SMITHFIELD, VA 23430-1715
(757) 365-8028
(757) 356-9451
Mailing address
919 S CHURCH ST, SMITHFIELD, VA 23430-1715
(757) 365-8028
(757) 356-9451

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101023326
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
381157
ANTHEM PROVIDER NUMBER
VA
01
41003
OPTIMA HEALTH PROVIDER NO
VA
05
5663016
VA
Enumeration date
12/02/2005
Last updated
07/25/2007
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