Healthcare Provider Details

I. General information

NPI: 1063875227
Provider Name (Legal Business Name): MICHAEL JOHN LUNSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 WELLNESS WAY
STATE COLLEGE PA
16803-6702
US

IV. Provider business mailing address

155 WELLNESS WAY
STATE COLLEGE PA
16803-6702
US

V. Phone/Fax

Practice location:
  • Phone: 814-234-7800
  • Fax: 814-231-7295
Mailing address:
  • Phone: 814-231-7000
  • Fax: 814-238-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD496322
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2022031957
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: