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NPI Code Detail

MEDICARE: NATHAN LEE LIN MD

MEDICARE: NATHAN LEE LIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036.162262IL

General Provider Information

NPI Number : 1245721174
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN LEE LIN MD
Provider Business Mailing Address
First Line : 2426 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-1735
Country : US
Telephone Number : 612-302-8200
Fax Number :
Provider Business Practice Location Address
First Line : 2426 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-1735
Country : US
Telephone Number : 612-302-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2018
Last Update Date : 07/24/2025

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