Provider Demographics
NPI:1417926098
Name:WALLING, LINDA L (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:WALLING
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Gender:F
Credentials:MD
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Mailing Address - Street 1:559 CAPITOL BLVD
Mailing Address - Street 2:6TH FLOOR - CLINICS ADMINISTRATION
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2101
Mailing Address - Country:US
Mailing Address - Phone:651-232-1699
Mailing Address - Fax:651-232-2009
Practice Address - Street 1:980 RICE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-4949
Practice Address - Country:US
Practice Address - Phone:651-326-9020
Practice Address - Fax:651-326-9021
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN26317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND80955Medicare UPIN