Provider Demographics
NPI:1356472724
Name:LUNDE, MARCIA ER (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:ER
Last Name:LUNDE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 11TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-4693
Mailing Address - Country:US
Mailing Address - Phone:701-852-7775
Mailing Address - Fax:701-852-7832
Practice Address - Street 1:111 11TH AVE SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4693
Practice Address - Country:US
Practice Address - Phone:701-852-7775
Practice Address - Fax:701-852-7832
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND737111N00000X
MN4535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13989Medicaid
ND23980OtherBCBS
NDU98715Medicare UPIN
ND23980OtherBCBS