Healthcare Provider Details

I. General information

NPI: 1477907319
Provider Name (Legal Business Name): LIN SHEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 DEATRICK DR
GETTYSBURG PA
17325-6958
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-339-2500
  • Fax: 717-339-2502
Mailing address:
  • Phone: 173-392-5007
  • Fax: 717-339-2502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6494
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS021541
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: