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Individual

JAMES EDGAR LUNDEEN SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
26 SANDUSKY ST, PLYMOUTH, OH 44865-1113
(419) 687-4322
(419) 687-4323
Mailing address
26 SANDUSKY ST, PLYMOUTH, OH 44865-1113
(419) 687-4322
(419) 687-4323

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
35052257
OH
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
35052257
OH
208D00000X
General Practice Physician
35052257
OH
208VP0000X
Pain Medicine Physician
35052257
OH
209800000X
Legal Medicine (M.D./D.O.) Physician
35052257
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0604322
OH
01
0808943
MEDICARE PTAN
OH
Enumeration date
10/10/2008
Last updated
02/25/2011
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