MEDICARE: CHRISTINE M LUNDMARK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	O1-0000707	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841461605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE M LUNDMARK

Provider Business Mailing Address
First Line	:	1004 MAPLE AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19809-3015
Country	:	US
Telephone Number	:	302-562-3120
Fax Number	:	302-454-5443

Provider Business Practice Location Address
First Line	:	1004 MAPLE AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19809-3015
Country	:	US
Telephone Number	:	302-562-3120
Fax Number	:	302-454-5443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	03/19/2008

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Directions to “ CHRISTINE M LUNDMARK ” Practice Location

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