Provider Demographics
NPI:1619029642
Name:LINDE, DEBBY ALISHA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBBY
Middle Name:ALISHA
Last Name:LINDE
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 1:3913 OLD LEE HWY
Mailing Address - Street 2:31C
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2433
Mailing Address - Country:US
Mailing Address - Phone:703-278-0444
Mailing Address - Fax:703-277-1962
Practice Address - Street 1:3913 OLD LEE HWY
Practice Address - Street 2:31C
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2433
Practice Address - Country:US
Practice Address - Phone:703-278-0444
Practice Address - Fax:703-277-1962
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010575822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2002339OtherCIGNA PROVIDER NUMBER