Provider Demographics
NPI:1659379394
Name:LUND, MICHAEL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:LUND
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2325 ABERDEEN BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0614
Mailing Address - Country:US
Mailing Address - Phone:704-853-3937
Mailing Address - Fax:704-853-0840
Practice Address - Street 1:2325 ABERDEEN BLVD
Practice Address - Street 2:STE A
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0614
Practice Address - Country:US
Practice Address - Phone:704-853-3937
Practice Address - Fax:704-853-0840
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-03-12
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Provider Licenses
StateLicense IDTaxonomies
NC9500988207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC56888OtherMEDCOST
NC53237OtherBLUE CROSS OF NC
NC8953237Medicaid
NC12993OtherPARTNERS MEDICARE CHOICE
NC53237OtherBLUE CROSS OF NC
NC0846090001Medicare NSC