Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | D0063545 | MD |
Y | 2080A0000X | Adolescent Medicine | MD051840-L | PA |
N | 2080A0000X | Adolescent Medicine | MD2006-0156 | NM |
NPI | 1215039177 |
---|---|
Provider Name | Dr. Thomas George Lundquist |
First Address | Mcmurray, PA 15317-3651 |
Second Address | Mcmurray, PA 15317-3651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 08/07/2007 |