Provider Demographics
NPI:1881976231
Name:BAYYAN, LINDA MALIKAH (RPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MALIKAH
Last Name:BAYYAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 W MERCURY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3807
Mailing Address - Country:US
Mailing Address - Phone:757-826-5522
Mailing Address - Fax:
Practice Address - Street 1:3326 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3807
Practice Address - Country:US
Practice Address - Phone:757-826-5522
Practice Address - Fax:757-826-1670
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist