Provider Demographics
NPI:1417915976
Name:LIN, ALLEN YISHIEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:YISHIEN
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1114 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2936
Mailing Address - Country:US
Mailing Address - Phone:434-799-0183
Mailing Address - Fax:434-799-6829
Practice Address - Street 1:1114 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2936
Practice Address - Country:US
Practice Address - Phone:434-799-0183
Practice Address - Fax:434-799-6829
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029644207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC061B3OtherBCBS
VA5794617Medicaid
VA011370OtherANTHEM
NC77906183Medicaid
VA011370OtherANTHEM