Healthcare Provider Details

I. General information

NPI: 1285627182
Provider Name (Legal Business Name): LINDA CAREN RUNYON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E STATE ST STERLING AREA HEALTH CENTER
STERLING MI
48659-9548
US

IV. Provider business mailing address

725 E STATE ST
STERLING MI
48659-9548
US

V. Phone/Fax

Practice location:
  • Phone: 989-654-2491
  • Fax: 989-654-2190
Mailing address:
  • Phone: 989-654-3384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number4301048990
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: