Provider Demographics
NPI:1922035138
Name:LINDEN, MELVIN D (DO)
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:D
Last Name:LINDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27031 W WARREN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1901
Mailing Address - Country:US
Mailing Address - Phone:313-274-3320
Mailing Address - Fax:313-730-9222
Practice Address - Street 1:27031 W WARREN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1901
Practice Address - Country:US
Practice Address - Phone:313-274-3320
Practice Address - Fax:313-730-9222
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101004671207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI129396OtherCARE CHOICES
MI4032884OtherAETNA
MI5821020OtherBLUE CROSS
MI4298758Medicaid
MIB0242OtherMCARE
MIP0826OtherBLUE CROSS
OM89760004Medicare ID - Type Unspecified
MIB0242OtherMCARE