Provider Demographics
NPI:1770699597
Name:CHIN-TI LIN, M.D., P.C.
Entity type:Organization
Organization Name:CHIN-TI LIN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHIN
Authorized Official - Middle Name:TI
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-230-0338
Mailing Address - Street 1:330 MEADOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-3052
Mailing Address - Country:US
Mailing Address - Phone:810-230-0338
Mailing Address - Fax:810-230-0595
Practice Address - Street 1:330 MEADOW CREEK DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-3052
Practice Address - Country:US
Practice Address - Phone:810-230-0338
Practice Address - Fax:810-230-0595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036928208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4379927Medicaid
MI3402506011OtherBLUE CROSS BLUE SHIELD
MI3402506011OtherBLUE CROSS BLUE SHIELD
MI4379927Medicaid