Provider Demographics
NPI:1053307843
Name:LINDE, STEVEN JOHN (PA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JOHN
Last Name:LINDE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1335 S PACIFIC AVE
Mailing Address - Street 2:1
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-1725
Mailing Address - Country:US
Mailing Address - Phone:928-920-8848
Mailing Address - Fax:928-782-2138
Practice Address - Street 1:1335 S PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-1725
Practice Address - Country:US
Practice Address - Phone:928-920-8848
Practice Address - Fax:928-782-2138
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ1087363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical