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BRYAN LUNDAHL
NPI 1073309183
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since April 16, 2025PECOS Enrolled
22201 MOROSS RD, DETROIT, MI 48236(313) 343-6530 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bryan Lundahl NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRYAN LUNDAHL (NPI 1073309183) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073309183
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBRYAN LUNDAHL
Location Address22201 MOROSS RDDetroit, MI 48236-2169
Mailing Address22201 Moross RdDetroit, MI 48236-2169 · (313) 343-6530
Phone(313) 343-6530
Sole ProprietorYes
Enumeration DateApril 16, 2025
NPPES CertifiedApril 16, 2025
✔ NPI 1073309183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
22201 MOROSS RD, Detroit, MI 48236
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bryan Lundahl is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RUDOLPH MENCHL JR. MD
Internal Medicine
22201 MOROSS RD, SUITE 150
DETROIT, MI 48236
Wayne County (313) 886-8787
DR. SAJITHAA VARADARASA M.D.
Student in an Organized Health Care Education/Training Program
22201 MOROSS RD, SUITE 50
DETROIT, MI 48236
Wayne County (313) 343-7774
DEEPAK GOPALBHAI PATEL MD
Pediatrics (Neonatal-Perinatal Medicine)
22201 MOROSS RD, 270
DETROIT, MI 48236
Wayne County (313) 343-3481
DR. ANDREY ALEX VOLKOV D.O
Neurological Surgery
22201 MOROSS RD, SUITE 352
DETROIT, MI 48236
Wayne County (313) 343-7900
JOHN THOMAS ADAMS MD
Pediatrics (Neonatal-Perinatal Medicine)
22201 MOROSS RD, 270
DETROIT, MI 48236
Wayne County (313) 343-3481
ST. JOHN HOSPITAL & MEDICAL CENTER
General Acute Care Hospital
22201 MOROSS RD, SUITE 50
DETROIT, MI 48236
Wayne County (313) 343-7774
ST. JOHN HOSPITAL AND MEDICAL CENTER
General Acute Care Hospital
22201 MOROSS RD, PROFESSIONAL BUILDING TWO, SUITE 50
DETROIT, MI 48236
Wayne County (313) 343-7774
NATALIE RENEE KONTOS DO
Pediatrics
22201 MOROSS RD, PROFESSIONAL BUILDING 2, SUITE 70
DETROIT, MI 48236
Wayne County (313) 343-4279

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bryan Lundahl's NPI number?

The NPI number for Bryan Lundahl is 1073309183. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Where is Bryan Lundahl located?

Bryan Lundahl practices at 22201 Moross Rd, Detroit, MI 48236. The listed phone number is (313) 343-6530.

What is Bryan Lundahl's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Bryan Lundahl enrolled in Medicare?

Yes. Bryan Lundahl is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bryan Lundahl was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.