Provider Demographics
NPI:1972538502
Name:LINZ AUDAIN, MD, LLC
Entity Type:Organization
Organization Name:LINZ AUDAIN, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AUDAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-602-1730
Mailing Address - Street 1:1313 DOLLEY MADISON BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3953
Mailing Address - Country:US
Mailing Address - Phone:703-734-8261
Mailing Address - Fax:
Practice Address - Street 1:1313 DOLLEY MADISON BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3953
Practice Address - Country:US
Practice Address - Phone:703-734-8261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101229841207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty