Provider Demographics
NPI:1306920350
Name:IRVINE, LINDA C (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:IRVINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3211
Mailing Address - Country:US
Mailing Address - Phone:330-928-2818
Mailing Address - Fax:330-928-1755
Practice Address - Street 1:2107 4TH ST
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3211
Practice Address - Country:US
Practice Address - Phone:330-928-2818
Practice Address - Fax:330-928-1755
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.054544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine