Healthcare Provider Details

I. General information

NPI: 1760708267
Provider Name (Legal Business Name): BERTINA FINWEI LIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HIGHLANDER POINT DR SUITE 300
FLOYDS KNOBS IN
47119-9465
US

IV. Provider business mailing address

800 HIGHLANDER POINT DR SUITE 204
FLOYDS KNOBS IN
47119-9465
US

V. Phone/Fax

Practice location:
  • Phone: 812-923-2273
  • Fax: 812-923-4100
Mailing address:
  • Phone: 812-542-4921
  • Fax: 812-949-5966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01074828A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier201268490
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: