Provider Demographics
NPI:1760592927
Name:LINFOOT, DINA WEISS (MD)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:WEISS
Last Name:LINFOOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DINA
Other - Middle Name:ELLEN
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4750 WATERS AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6270
Mailing Address - Country:US
Mailing Address - Phone:912-350-5937
Mailing Address - Fax:912-350-3483
Practice Address - Street 1:4750 WATERS AVE STE 400
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404
Practice Address - Country:US
Practice Address - Phone:912-350-5937
Practice Address - Fax:912-350-3483
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039696207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA609481158DMedicaid
SCG39696Medicaid
GA609481158CMedicaid
GA609481158BMedicaid
GA624535OtherWELLCARE
GAP00386150OtherRR MEDICARE
GA01052367OtherAMERIGROUP
GA404115OtherWELLCARE
GA609481158AMedicaid
GA609481158BMedicaid
GA609481158AMedicaid