Individual
LINCOLN H GUNDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
28234
WI
2085R0204X
Vascular & Interventional Radiology Physician
34334
IA
2085R0204X
Vascular & Interventional Radiology Physician
44702
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31487400
—
WI
Enumeration date
06/22/2005
Last updated
09/22/2015
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