Provider Demographics
NPI:1427286566
Name:DULA, LINDA YANIK (DO)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:YANIK
Last Name:DULA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 603250
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3250
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:360 HOSPITAL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-0107
Practice Address - Country:US
Practice Address - Phone:828-456-9006
Practice Address - Fax:828-456-8199
Is Sole Proprietor?:No
Enumeration Date:2009-06-28
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2011-00106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC0561F135OtherMEDICARE PTAN