Individual
ERIC C LUNDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
605 S MAIN ST, DU BOIS, PA 15801-1479
(814) 371-8569
(814) 371-8603
Mailing address
605 S MAIN ST, DU BOIS, PA 15801-1479
(814) 371-8569
(814) 371-8603
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD041884E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012492680003
—
PA
01
—
020051707
RAILROAD MEDICARE
PA
Enumeration date
09/22/2005
Last updated
12/22/2014
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