Provider Demographics
NPI:1295836864
Name:LINDERMAN, CATHERINE L (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:LINDERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 E SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-8280
Mailing Address - Country:US
Mailing Address - Phone:208-524-0610
Mailing Address - Fax:208-557-0171
Practice Address - Street 1:2375 E SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-8280
Practice Address - Country:US
Practice Address - Phone:208-524-0610
Practice Address - Fax:208-557-0171
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-6069261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1262500Medicaid
ID10136831OtherBLUE SHIELD
IDJ5842OtherBLUE CROSS
ID1126281Medicare ID - Type Unspecified
ID1262500Medicaid