Provider Demographics
NPI:1649268343
Name:LINDEN, PHILIP A (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:A
Last Name:LINDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-5770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78160208G00000X
OH35-090466208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000225071OtherUNISON #
OH2762630Medicaid
MA3137911Medicaid
OH415002OtherWELLCARE #
OH7856284OtherAETNA #
OH000000533899OtherANTHEM #
OHP00449213OtherRAILROAD MEDICARE
OH751170OtherBUCKEYE #
MA3137911Medicaid
OHLI4217221Medicare PIN
OH415002OtherWELLCARE #