Provider Demographics
NPI:1023424991
Name:EDWIN, LINI
Entity type:Individual
Prefix:
First Name:LINI
Middle Name:
Last Name:EDWIN
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 1:110 IRVING ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-0393
Mailing Address - Fax:202-877-7973
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-8278
Practice Address - Fax:202-877-6292
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD045151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine