MEDICARE: LINDUC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	062127	GA
2	207R00000X	Internal Medicine Physician	062127	GA

General Provider Information

NPI Number	:	1609162965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDUC PC

Provider Business Mailing Address
First Line	:	2680 LAWRENCEVILLE HWY STE 202
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-2526
Country	:	US
Telephone Number	:	470-250-1418
Fax Number	:	770-674-7626

Provider Business Practice Location Address
First Line	:	2680 LAWRENCEVILLE HWY STE 202
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-2526
Country	:	US
Telephone Number	:	470-250-1418
Fax Number	:	770-674-7626

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	UCHENNA PETER KALU
Credential	:	M.D.
Telephone Number	:	470-250-1418

Provider Enumeration Date	:	06/24/2011
Last Update Date	:	03/11/2019

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