Healthcare Provider Details

I. General information

NPI: 1669683967
Provider Name (Legal Business Name): CHRISTOPHER ALAN LUNDQUIST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 MCGREGOR STREET SUITE 3100
MANCHESTER NH
03102-3731
US

IV. Provider business mailing address

103 MAYWOOD WAY
CHAPEL HILL NC
27516
US

V. Phone/Fax

Practice location:
  • Phone: 603-627-1887
  • Fax: 603-627-1890
Mailing address:
  • Phone: 513-509-5074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17837
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2012-01184
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: