CONOR F LUNDERGAN (NPI# 1376524579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376524579 |
| Entity Type | Individual |
| Full Name | CONOR F LUNDERGAN |
| Credential | M.D. |
| Practice Address |
12070 Old Line Ctr Ste 303 Waldorf MD 20602 |
| Practice Telephone | 3014753240 |
| Practice Fax Number | 3014759740 |
| Mailing Telephone | 3014753240 |
| Mailing Fax Number | 3014759740 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
29618 | NC | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD17986 | DC | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
D0034663 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | BCBS | 606188-03 | 01 |
| Street Address |
12070 OLD LINE CTR STE 303 |
| City | WALDORF |
| State | MD |
| Zip Code | 20602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206412 | Douglas Avery & Associates Ltd | Clinic/Center | 12070 Old Line Ctr, Ste 107, Waldorf, MD 20602-2503 | 2005-06-21 |
| 1104467463 | Maryland Pain & Regenerative Center, LLC | Pain Medicine | 12070 Old Line Ctr, Waldorf, MD 20602-2513 | 2019-10-07 |
| 1578947305 | Larry S. Hotchkiss, Dpm PC | Non-Pharmacy Dispensing Site | 12070 Old Line Ctr, #110, Waldorf, MD 20602-2513 | 2015-07-10 |
| 1851791735 | Pro-perform Spinal Health & Rehab LLC | Chiropractor | 12070 Old Line Ctr, Suite 301, Waldorf, MD 20602-2513 | 2014-08-28 |
| 1427494343 | Denise Colton | Nurse Practitioner | 12070 Old Line Ctr, Suite 302, Waldorf, MD 20602-2513 | 2013-05-18 |
| 1659636082 | Justin G. Pointer | Podiatrist | 12070 Old Line Ctr, Suite 110, Waldorf, MD 20602-2513 | 2012-07-11 |
| 1538437223 | Christine T Gardella | Physician Assistant | 12070 Old Line Ctr, Suite 302, Waldorf, MD 20602-2513 | 2011-12-08 |
| 1265670046 | Dawn Stephanie Christopher | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2009-02-02 |
| 1548406960 | Surgical Associates, Chartered | Surgery | 12070 Old Line Ctr, Suite 306, Waldorf, MD 20602-2513 | 2009-01-07 |
| 1386812113 | Elizabeth Hurt | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2008-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964957 | Haeyoung Choi | Pharmacist | 25 Smallwood Village Center, Waldorf, MD 20602 | 2019-07-19 |
| 1679137194 | Brighter Days Family Services Inc | Counselor | 11680 Doolittle Dr #111, Waldorf, MD 20602 | 2019-04-30 |
| 1396227039 | Lantern Family Services Inc | Community/Behavioral Health | 11680 Doolittle Dr Ste 111, Waldorf, MD 20602 | 2018-08-29 |
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1174009922 | Dr. Arthur B. Sorkin, D.d.s., LLC | Dentist | 3460 Old Washington Rd., Suite 301-b, Waldorf, MD 20602 | 2018-07-16 |
| 1467945030 | Donna Marie Conley-shaw | Behavior Technician | 16 Pagnell Cir, Waldorf, MD 20602 | 2018-06-08 |
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1891224853 | Linda E Smith | Social Worker | 605 Pst Office Road, #301, Waldorf, MD 20602 | 2017-06-05 |
| 1104373273 | Love Ngum Che | Pharmacist | 25 Smallwood Village, Waldorf, MD 20602 | 2016-09-07 |
| 1639543341 | Matengy Toure | Pharmacist | 129 St Charles Pkwy, Waldorf, MD 20602 | 2015-11-18 |
| Find all providers in zip 20602 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437412566 | Awail U Sadiq | Internal Medicine | 12070 Old Line Ctr Ste 303, Waldorf, MD 20602-3535 | 2012-06-22 |
| 1639490840 | Jonathan David Gardner | Internal Medicine | 12070 Old Line Ctr Ste 303, Waldorf, MD 20602-3535 | 2010-06-22 |
| 1265553960 | Jerry Salan | Internal Medicine | 13464 Holly Spring Dr, Waldorf, MD 20601-2329 | 2007-04-02 |
| 1760587596 | Samuel B Itscoitz | Internal Medicine | 12070 Old Line Ctr Ste 303, Waldorf, MD 20602-3535 | 2006-09-14 |
| 1669585113 | Chesapeake&washington Heart Care, PC | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2006-08-17 |
| 1790702157 | Jeffrey B Trabb | Internal Medicine | 2670 Crain Hwy, Suite 300, Waldorf, MD 20601-2806 | 2006-07-15 |
| 1699714469 | Maryland Healthcare Associates LLC | Internal Medicine | 12070 Old Line Ctr, Suite 100, Waldorf, MD 20602-2513 | 2006-06-06 |
| 1669438933 | Terrance A. Collins | Internal Medicine | 2670 Crain Hwy, Suite 300, Waldorf, MD 20601-2806 | 2006-04-25 |
| 1699746271 | Thomas B Haywood | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2006-01-31 |
| 1356322598 | Satish Jumani | Internal Medicine | 12070 Old Line Ctr, Suite 202, Waldorf, MD 20602-2513 | 2005-11-07 |
| Find all providers in WALDORF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.