Provider Demographics
NPI:1609047844
Name:IDUN, LINDA DZIFA (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:DZIFA
Last Name:IDUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:DZIFA
Other - Last Name:GIDIGASU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1141 N MONROE DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-1619
Mailing Address - Country:US
Mailing Address - Phone:937-352-2581
Mailing Address - Fax:937-352-3580
Practice Address - Street 1:1141 N MONROE DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1619
Practice Address - Country:US
Practice Address - Phone:937-352-2581
Practice Address - Fax:937-352-3580
Is Sole Proprietor?:No
Enumeration Date:2008-03-16
Last Update Date:2008-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH090786208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist