Provider Demographics
NPI:1760059216
Name:ALFRED, LINDA SHERINE
Entity Type:Individual
Prefix:
First Name:LINDA SHERINE
Middle Name:
Last Name:ALFRED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6071 W. OUTER DRIVE 4TH FLOOR M-408
Mailing Address - Street 2:DEPARTMENT OF MEDICINE / TRANSITIONAL YEAR PROGRAM
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-966-1728
Mailing Address - Fax:
Practice Address - Street 1:6071 W. OUTER DRIVE 4TH FLOOR M-408
Practice Address - Street 2:DEPARTMENT OF MEDICINE / TRANSITIONAL YEAR PROGRAM
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-966-1728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program