Provider Demographics
NPI:1609880368
Name:SEWELL, LINDA L (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:SEWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2564 NW EDENBOWER BLVD
Mailing Address - Street 2:STE 134
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471
Mailing Address - Country:US
Mailing Address - Phone:541-492-2350
Mailing Address - Fax:541-492-2346
Practice Address - Street 1:2564 NW EDENBOWER BLVD
Practice Address - Street 2:STE 134
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471
Practice Address - Country:US
Practice Address - Phone:541-492-2350
Practice Address - Fax:541-492-2346
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2012-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD26760207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1609880368OtherINDIVIDUAL NPI NUMBER
ORI60118Medicare UPIN
ORR151626Medicare PIN