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General NPI Number Information
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NPI Number | 1356469068
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Entity Type | Individual
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Provider Name | LINDA BENNETT SOLOMON PAC
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10274 LAKE ARBOR WAY SUITE 202
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City | MITCHELLVILLE
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State | MD
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Zip | 20721
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Country | US
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Telephone | 301-336-9065
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Fax | 301-336-6909
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Provider Business Mailing Address
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Address Line | 11315 OLD PROSPECT HILL RD
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City | GLENN DALE
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State | MD
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Zip | 20769
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Country | US
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Telephone | 301-352-5874
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C01561
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License Number State | MD
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