Provider Demographics
NPI:1578610663
Name:TARTELL, LINDA SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:SUSAN
Last Name:TARTELL
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 1:2200 GAR HWY
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3935
Mailing Address - Country:US
Mailing Address - Phone:508-379-9605
Mailing Address - Fax:508-379-9813
Practice Address - Street 1:2200 GAR HWY
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3935
Practice Address - Country:US
Practice Address - Phone:508-379-9605
Practice Address - Fax:508-379-9813
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA393392080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine