Provider Demographics
NPI:1013938885
Name:LUNDE, NORMAN MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:MARTIN
Last Name:LUNDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SHINGLE CREEK PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2128
Mailing Address - Country:US
Mailing Address - Phone:763-561-5349
Mailing Address - Fax:763-561-7792
Practice Address - Street 1:6200 SHINGLE CREEK PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2128
Practice Address - Country:US
Practice Address - Phone:763-561-5349
Practice Address - Fax:763-561-7792
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN35209207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP13866OtherHEALTHPARTNERS
MN33006OtherPREFERRED ONE
MNIM0509OtherAMERICA'S PPO
MNIM439LUOtherBCBSMN
MN3100243OtherMEDICA
WI32532400Medicaid
MN103618C028OtherUCARE
MN624202200Medicaid
WI32532400Medicaid
MN390000131Medicare PIN
MNIM439LUOtherBCBSMN