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General NPI Number Information
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NPI Number | 1528099462
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Entity Type | Individual
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Provider Name | LINDA I GREENSPAN D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 301 S CAMPBELL ST
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City | BURGAW
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State | NC
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Zip | 28425-5011
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Country | US
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Telephone | 910-259-5721
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Fax | 910-259-8002
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Provider Business Mailing Address
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Address Line | 301 S CAMPBELL ST
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City | BURGAW
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State | NC
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Zip | 28425-5011
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Country | US
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Telephone | 910-259-5721
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Fax | 910-259-8002
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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 | 25MB05664900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2006-01488
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License Number State | NC
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