Provider Demographics
NPI:1336147024
Name:WINEGARDNER, LINDA STILL (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:STILL
Last Name:WINEGARDNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9718 SAM FURR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4929
Mailing Address - Country:US
Mailing Address - Phone:704-987-7970
Mailing Address - Fax:704-987-8221
Practice Address - Street 1:9718 SAM FURR RD
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4929
Practice Address - Country:US
Practice Address - Phone:704-987-7970
Practice Address - Fax:704-987-8221
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801807207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891178MMedicaid
NC2266477CMedicare PIN
G24051Medicare UPIN