Provider Demographics
NPI:1356447650
Name:GERARD, LINDA LAMM (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LAMM
Last Name:GERARD
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:PO BOX 1117
Mailing Address - Street 2:10025 FORD AVE., SUITE 3-A
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-1117
Mailing Address - Country:US
Mailing Address - Phone:912-756-3404
Mailing Address - Fax:912-756-2156
Practice Address - Street 1:10025 FORD AVE
Practice Address - Street 2:SUITE 3-A
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-8804
Practice Address - Country:US
Practice Address - Phone:912-756-3404
Practice Address - Fax:912-756-2156
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA028168207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000313255BMedicaid
16BDBBMMedicare ID - Type Unspecified
GA000313255BMedicaid