Provider Demographics
NPI:1689630402
Name:MOTSCH, LINDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:MOTSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:18185 N 83RD AVE
Mailing Address - Street 2:BLDG D, SUITE 107
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-0516
Mailing Address - Country:US
Mailing Address - Phone:623-583-0306
Mailing Address - Fax:623-583-1349
Practice Address - Street 1:18185 N 83RD AVE
Practice Address - Street 2:BLDG D, SUITE 107
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-0516
Practice Address - Country:US
Practice Address - Phone:623-583-0306
Practice Address - Fax:623-583-1349
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ24028207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ367913Medicaid
AZZ83692Medicare PIN
AZG33312Medicare UPIN