Provider Demographics
NPI:1235290420
Name:LUNDQUIST, ANDREW D (DPM)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:LUNDQUIST
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:PO BOX 8674
Mailing Address - Street 2:1230 E MAIN ST MANKATO CLINIC LTD
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1901 OID MINNESOTA AVE
Practice Address - Street 2:MANKATO CLINIC @ DANIEL'S HEALTH CENTER
Practice Address - City:ST. PETER
Practice Address - State:MN
Practice Address - Zip Code:56082
Practice Address - Country:US
Practice Address - Phone:507-934-2325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2020-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5901002170213ES0103X
MN786213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP80446OtherHEALTH PARTNERS
MN844615100Medicaid
SD63371OtherSANFORD HEALTH PLAN SD
MN139607OtherUCARE
MNHP80446OtherMN HEALTH PARTNERS
MN211D6LUOtherBCBS
MN1235290420OtherAMERICAS PPO
63371OtherSANFORD HEALTH PLAN
MNNA2951051682OtherPREFERRED ONE
MNP00630161OtherRR MEDICARE - MN
MNP00630161OtherRR MEDICARE - MN