Provider Demographics
NPI:1821089152
Name:LINDERT, DAVID JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JONATHAN
Last Name:LINDERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-0054
Mailing Address - Country:US
Mailing Address - Phone:740-671-9765
Mailing Address - Fax:740-695-3559
Practice Address - Street 1:20 MEDICAL PARK
Practice Address - Street 2:SUITE 201
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6390
Practice Address - Country:US
Practice Address - Phone:740-671-9765
Practice Address - Fax:740-695-3559
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV10594208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0130883000Medicaid
OH0357126Medicaid
WV0130883000Medicaid
WV0414984Medicare ID - Type Unspecified
OH0357126Medicaid