Individual
JOHN GILBERT LUNDEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
406 ELM ST, CARSON CITY, MI 48811
(989) 584-3971
(989) 584-2161
Mailing address
PO BOX 1108, ATTN BARB SIMMONS, ANN ARBOR, MI 48106-1108
(734) 677-7400
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301023938
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4085919
—
MI
01
—
CA3518
MEDICARE RR GROUP PIN
MI
Enumeration date
07/19/2006
Last updated
11/02/2007
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