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General NPI Number Information
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NPI Number | 1417916677
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Entity Type | Organization
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Legal Business Name | LINDERMAN PEDIATRIC ASSOCIATES
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 167L S TRADE ST
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City | MATTHEWS
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State | NC
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Zip | 28105-5771
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Country | US
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Telephone | 704-847-0757
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Fax | 704-844-2068
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Provider Business Mailing Address
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Address Line | PO BOX 2563
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City | MATTHEWS
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State | NC
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Zip | 28106-2563
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Country | US
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Telephone | 704-847-0757
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Fax | 704-844-2068
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Authorized Official
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Title or Position | INSURANCE MANAGER
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Name | SUSAN B COEN
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Credential |
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Telephone | 704-847-0757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 25046
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License Number State | NC
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