Provider Demographics
NPI:1063514727
Name:NORRELL, LINDA D (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:D
Last Name:NORRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1515 W ATHERTON RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-5300
Mailing Address - Country:US
Mailing Address - Phone:810-238-1771
Mailing Address - Fax:810-232-9134
Practice Address - Street 1:1515 W ATHERTON RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-5300
Practice Address - Country:US
Practice Address - Phone:810-238-1771
Practice Address - Fax:810-232-9134
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301044844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3236080Medicaid
MIM23560043Medicare PIN
MIB43287Medicare UPIN