Provider Demographics
NPI:1598968174
Name:LINDA BRASHEAR MD, INC.
Entity Type:Organization
Organization Name:LINDA BRASHEAR MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BRASHEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-869-8440
Mailing Address - Street 1:484 S MILLER RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4176
Mailing Address - Country:US
Mailing Address - Phone:330-869-8440
Mailing Address - Fax:330-564-0740
Practice Address - Street 1:484 S MILLER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4176
Practice Address - Country:US
Practice Address - Phone:330-869-8440
Practice Address - Fax:330-564-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079750B207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLI9332661Medicare ID - Type UnspecifiedGROUP NUMBER
OHH63412Medicare UPIN