Provider Demographics
NPI:1326209776
Name:LIN, CHRISTINE SHAN-SHAN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SHAN-SHAN
Last Name:LIN
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 1:706 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7038
Mailing Address - Country:US
Mailing Address - Phone:336-387-2500
Mailing Address - Fax:
Practice Address - Street 1:706 GREEN VALLEY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7038
Practice Address - Country:US
Practice Address - Phone:336-387-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205376207ZD0900X
SC38412207ZP0102X
NC2015-02362207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology