Provider Demographics
NPI:1700870961
Name:WILMARTH, LINDA K (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:WILMARTH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6950 FRANCE AVE S
Mailing Address - Street 2:MPLS RADIATION ONCOLOGY
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2025
Mailing Address - Country:US
Mailing Address - Phone:952-920-4915
Mailing Address - Fax:952-915-6091
Practice Address - Street 1:6950 FRANCE AVE S
Practice Address - Street 2:MPLS RADIATION ONCOLOGY
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2025
Practice Address - Country:US
Practice Address - Phone:952-920-4915
Practice Address - Fax:952-915-6091
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN412652085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32491400Medicaid
MN795415OtherAMERICA'S PPO
MN24-00061OtherMEDICA
MN9630701023544OtherPREFERRED ONE
MN110589OtherPT CHOICE
MN123132OtherUCARE
MN24-00004OtherMEDICA PRIMARY
MN31B90WIOtherBLUE CROSS/BLUE SHIELD
MNHP38132OtherHEALTH PARTNER
MN9630701023544OtherPREFERRED ONE