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General NPI Number Information
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NPI Number | 1972614923
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Entity Type | Individual
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Provider Name | MARK STEVEN LUND O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6 GRAND CORNER AVE
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City | GAITHERSBURG
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State | MD
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Zip | 20878-7303
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Country | US
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Telephone | 301-948-2020
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Fax | 301-948-1010
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Provider Business Mailing Address
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Address Line | 410 LONG TRAIL TER
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City | ROCKVILLE
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State | MD
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Zip | 20850-7763
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Country | US
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Telephone | 301-762-2974
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Fax | 301-762-2975
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001380
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA1880
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T3196
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License Number State | TX
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