Provider Demographics
NPI:1821453960
Name:LUND, ALEXIS (DPM)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:LUND
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 YORKLYN RD STE 350
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8740
Mailing Address - Country:US
Mailing Address - Phone:302-239-1625
Mailing Address - Fax:302-239-1626
Practice Address - Street 1:319 W BROAD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-1343
Practice Address - Country:US
Practice Address - Phone:609-386-0217
Practice Address - Fax:609-386-0102
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1-0000255213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist