MEDICARE: DR. MICHAEL SCOTT LINN 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	207XX0801X	Orthopaedic Trauma Physician	2013005682	MO
2	207XX0801X	Orthopaedic Trauma Physician	275597	NY

General Provider Information

NPI Number	:	1679779193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SCOTT LINN MD

Provider Business Mailing Address
First Line	:	217 E MAIN ST
Second Line	:	SOUTHSIDE HOSPITAL
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8407
Country	:	US
Telephone Number	:	631-647-3800
Fax Number	:	631-675-4206

Provider Business Practice Location Address
First Line	:	217 E MAIN ST
Second Line	:	SOUTHSIDE HOSPITAL
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8407
Country	:	US
Telephone Number	:	631-647-3800
Fax Number	:	631-675-4206

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

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	10/24/2014

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