Individual
ANDREW HAYWARD LUNDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
235 TYSON AVE, PARIS, TN 38242-4544
(731) 644-3211
(731) 644-1552
Mailing address
235 TYSON AVE, PARIS, TN 38242-4544
(731) 644-3211
(731) 644-1552
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD29285
TN
2086S0129X
Vascular Surgery Physician
Primary
MD29285
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3881424
—
TN
01
—
4075410
BLUECROSSBLUESHIELD NUMBR
TN
01
—
DB4003
RAILROAD MEDICARE GROUP
TN
01
—
P00113129
RAILROAD MEDICARE INDIVID
TN
Enumeration date
07/14/2006
Last updated
11/05/2007
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