Provider Demographics
NPI:1528385606
Name:DOCTOR, LYNNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:M
Last Name:DOCTOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:95 HIGHLAND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9424
Mailing Address - Country:US
Mailing Address - Phone:610-868-1100
Mailing Address - Fax:610-868-1111
Practice Address - Street 1:95 HIGHLAND AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9424
Practice Address - Country:US
Practice Address - Phone:610-868-1100
Practice Address - Fax:610-868-1111
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2016-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH390200000X
PAMD4554132086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program