Basic Information
Provider Information
NPI: 1649449273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LUNOE
FirstName: LEIF
MiddleName: CHESNUT
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3300 PROVIDENCE DR STE 207
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995084620
CountryCode: US
TelephoneNumber: 9075610005
FaxNumber: 9075639140
Practice Location
Address1: 3300 PROVIDENCE DR STE 207
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995084620
CountryCode: US
TelephoneNumber: 9075610005
FaxNumber: 9075639140
Other Information
ProviderEnumerationDate: 02/28/2008
LastUpdateDate: 06/22/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X6020084-1205UTY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home