Provider Demographics
NPI:1477907319
Name:SHEN, LIN (DO)
Entity Type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:173-392-5007
Mailing Address - Fax:717-339-2502
Practice Address - Street 1:18 DEATRICK DR
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-6958
Practice Address - Country:US
Practice Address - Phone:717-339-2500
Practice Address - Fax:717-339-2502
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6494207Q00000X
390200000X
PAOS021541207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program