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NPI Code Detail

MEDICARE: DAVID LINDSTROM MD

MEDICARE: DAVID LINDSTROM 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
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician35046513OH
2207P00000XEmergency Medicine Physician35-046513OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000246969OTHEROHANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000550245OTHEROHANTHEM

General Provider Information

NPI Number : 1770584526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID LINDSTROM MD
Provider Business Mailing Address
First Line : PO BOX 633390
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-3390
Country : US
Telephone Number : 419-690-7900
Fax Number :
Provider Business Practice Location Address
First Line : 2801 BAY PARK DR
Second Line :
City : OREGON
State : OH
Zip : 43616-4920
Country : US
Telephone Number : 419-690-7900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 03/08/2009

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Directions to “ DAVID LINDSTROM MD” Practice Location

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