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General NPI Number Information
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NPI Number | 1659550093
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Entity Type | Individual
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Provider Name | LINDA MEWIS CHRISTMANN MD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 06/12/2017
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Provider Practice Location Address
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Address Line | 3495 PIEDMONT ROAD, NE, BLDG. 9 THE SOUTHEAST PERMANENTE MEDICAL GROUP, INC.
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City | ATLANTA
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State | GA
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Zip | 30305
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Country | US
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Telephone | 404-364-4272
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Fax | 318-448-4903
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Provider Business Mailing Address
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Address Line | 5308 FAIRFIELD BLVD
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City | BRADENTON
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State | FL
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Zip | 34203-8028
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Country | US
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Telephone | 252-218-2996
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Fax | 318-448-4903
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 2007-01550
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License Number State | NC
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