MEDICARE: JOHN QUAN 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
1	207P00000X	Emergency Medicine Physician	4301045242	MI

General Provider Information

NPI Number	:	1538173182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN QUAN LIN MD

Provider Business Mailing Address
First Line	:	6799 WING LAKE RD
Second Line	:
City	:	BLOOMFIELD
State	:	MI
Zip	:	48301-2957
Country	:	US
Telephone Number	:	248-538-9979
Fax Number	:

Provider Business Practice Location Address
First Line	:	6799 WING LAKE RD
Second Line	:
City	:	BLOOMFIELD
State	:	MI
Zip	:	48301-2957
Country	:	US
Telephone Number	:	248-538-9979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/08/2007

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