Healthcare Provider Details

I. General information

NPI: 1194768275
Provider Name (Legal Business Name): LINDA N SEVIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12221-3 TULLAMORE ROAD MEDICAL CARE CENTER AT MAYS CHAPEL
LUTHERVILLE-TIMONIUM MD
21093
US

IV. Provider business mailing address

2401 W BELVEDERE AVE ATTN: CREDENTIALING
BALTIMORE MD
21215-5216
US

V. Phone/Fax

Practice location:
  • Phone: 410-308-7845
  • Fax: 410-308-7809
Mailing address:
  • Phone: 410-601-5524
  • Fax: 410-601-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD34586
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: