Provider Demographics
NPI:1336276427
Name:LIN, ALICE ANGELA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:ANGELA
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3320 EXECUTIVE DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7445
Mailing Address - Country:US
Mailing Address - Phone:919-876-2427
Mailing Address - Fax:919-850-9234
Practice Address - Street 1:3320 EXECUTIVE DR
Practice Address - Street 2:SUITE 111
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7445
Practice Address - Country:US
Practice Address - Phone:919-876-2427
Practice Address - Fax:919-850-9234
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2021-06-15
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Provider Licenses
StateLicense IDTaxonomies
OH57.009179207W00000X
VA0101245928207W00000X
NC2007-00374207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2066589Medicare PIN