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General NPI Number Information
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NPI Number | 1477491728
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Entity Type | Individual
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Provider Name | KEVIN JIAWEN LIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR # TC-B1380
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 631-974-0267
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MAYMONT LN
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City | STONY BROOK
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State | NY
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Zip | 11790-2908
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Country | US
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Telephone | 631-974-0267
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 207PE0004X
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License Number State | MI
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