Provider Demographics
NPI:1669458329
Name:SZABO, LINDA SUE (MD)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUE
Last Name:SZABO
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 1:7640 SYLVANIA AVE
Mailing Address - Street 2:D1
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9729
Mailing Address - Country:US
Mailing Address - Phone:419-841-4099
Mailing Address - Fax:419-841-8125
Practice Address - Street 1:7640 SYLVANIA AVE
Practice Address - Street 2:D1
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9729
Practice Address - Country:US
Practice Address - Phone:419-841-4099
Practice Address - Fax:419-841-8125
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062012174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00403186OtherRRMED
OH2757977Medicaid
000000515746OtherANTHEM
9367681Medicare PIN
E98649Medicare UPIN