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Individual

GINA P LUNDBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
137 JOHNSON FERRY RD, SUITE 1200, MARIETTA, GA 30068-4945
(678) 843-9601
(678) 843-9650
Mailing address
1838 AMERICAN WAY, LAWRENCEVILLE, GA 30043-6611
(770) 995-7622
(770) 995-7854

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
032458
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000604172N
GA
05
000604172P
GA
05
00604172A
GA
05
00604172O
GA
Enumeration date
07/25/2006
Last updated
03/27/2013
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