Lundstrom, Paul
Lundstrom, Paul is an individual health care provider with primary practice located at 13359 Isle Dr Suite 3, Baxter MN 56425-2222. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Lundstrom, Paul can be contacted via phone (218) 454-7546.Contact Information
Primary practice address
13359 Isle Dr Suite 3
Baxter MN 56425-2222
Phone: (218) 454-7546
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 45453 | Minnesota |
Profile Details
| NPI number | 1699759647 |
|---|---|
| LBN Legal business name | Lundstrom, Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 2nd, 2005 |
| Last updated | Jun 12th, 2024 - about last year |
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 | 1699759647 | NPPES |
| Minnesota | MEDICAID | 741720900 |
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