Basic Information
| Provider Information | |||||||||
| NPI: | 1982645925 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIN | ||||||||
| FirstName: | GERALD | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7500 GREENWAY CENTER DR | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | GREENBELT | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207703502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014772000 | ||||||||
| FaxNumber: | 3014742389 | ||||||||
| Practice Location | |||||||||
| Address1: | 7500 GREENWAY CENTER DR | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | GREENBELT | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207703502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014772000 | ||||||||
| FaxNumber: | 3014742389 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 01/25/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | D0021043 | MD | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 4053195 | 01 | AETNA PPO | OTHER | M23337 | 01 | MD | CDS | OTHER | 432105237 | 01 | BRAVO HEALTH | OTHER | 1901969 | 01 | UNITED HEALTHCARE AMERICHOICE | OTHER | 35400802 | 01 | BCBS MD | OTHER | 57620007 | 01 | BCBS DC | OTHER | P00459791 | 01 | RAILROAD MEDICARE | OTHER | AH1701576 | 01 | DEA | OTHER | 1467383 | 01 | AETNA HMO | OTHER |