Provider Demographics
NPI:1780779892
Name:LIN, JEFFREY PAI-CHIN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PAI-CHIN
Last Name:LIN
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 1:700 E MOREHEAD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 E MOREHEAD ST STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2742
Practice Address - Country:US
Practice Address - Phone:704-334-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD600859252085R0202X, 2085N0904X
NC2022-030332085R0202X
ORMD1646692085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2004508Medicaid
WA0251670OtherL&I-UNION AVE OPEN MRI
WA0251663OtherL&I-TRA REST OF WA
WA0395511OtherL&I-DIAGNOSTIC IMAGING NW
OR500671176Medicaid
WA0251663OtherL&I
WA0251670OtherL&I
WAG8886912Medicare PIN
WA0251663OtherL&I
WA0251670OtherL&I
PA126749D2YMedicare PIN
WAG8890069Medicare PIN