Provider Demographics
NPI:1770560377
Name:LUNT, PETER GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:GEORGE
Last Name:LUNT
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:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-0355
Mailing Address - Fax:
Practice Address - Street 1:301 MEMORIAL MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5167
Practice Address - Country:US
Practice Address - Phone:386-231-3147
Practice Address - Fax:386-231-3695
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9366207L00000X
FLME103724207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037469602Medicaid
TX037469603Medicaid
TX037469604Medicaid
TX8C9849Medicare ID - Type Unspecified339K
TX8D0032Medicare ID - Type Unspecified606K
TX037469602Medicaid
TX8J5188Medicare PIN
TX037469603Medicaid