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General NPI Number Information
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NPI Number | 1063481919
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Entity Type | Individual
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Provider Name | LINDA L MCINTIRE MD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 4540 BOULDER POND DR
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City | ANN ARBOR
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State | MI
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Zip | 48108-8595
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Country | US
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Telephone | 734-222-1644
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 WELLNESS DR
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City | MIDLAND
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State | MI
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Zip | 48670-2000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 92984
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301072984
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License Number State | MI
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