Lundgren, Eric C
Lundgren, Eric C is an sole proprietor health care provider with primary practice located at 605 S Main St , Du Bois PA 15801-1479. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Lundgren, Eric C can be contacted via phone (814) 371-8569.Contact Information
Primary practice address
605 S Main St
Du Bois PA 15801-1479
Phone: (814) 371-8569
Fax: (814) 371-8603
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD041884E | Pennsylvania |
Profile Details
NPI number | 1992791206 |
---|---|
LBN Legal business name | Lundgren, Eric C |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 22nd, 2005 |
Last updated | Dec 22nd, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1992791206 | NPPES |
Pennsylvania | MEDICAID | 0012492680003 | |
Pennsylvania | Other | 020051707 |
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