Provider Demographics
NPI:1396742839
Name:LIN, JULIANNE C (MD)
Entity type:Individual
Prefix:DR
First Name:JULIANNE
Middle Name:C
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 LIMESTONE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1247
Mailing Address - Country:US
Mailing Address - Phone:302-993-0931
Mailing Address - Fax:
Practice Address - Street 1:5305 LIMESTONE RD STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1247
Practice Address - Country:US
Practice Address - Phone:302-993-0931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI5600207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001089201Medicaid
DE490613Medicare ID - Type Unspecified
DE0001089201Medicaid