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General NPI Number Information
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NPI Number | 1417926098
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Entity Type | Individual
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Provider Name | LINDA L WALLING MD
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Gender | Female
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 980 RICE ST
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City | SAINT PAUL
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State | MN
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Zip | 55117-4949
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Country | US
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Telephone | 651-326-9020
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Fax | 651-326-9021
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Provider Business Mailing Address
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Address Line | 559 CAPITOL BLVD 6TH FLOOR - CLINICS ADMINISTRATION
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City | SAINT PAUL
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State | MN
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Zip | 55103-2101
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Country | US
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Telephone | 651-232-1699
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Fax | 651-232-2009
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26317
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License Number State | MN
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