Provider Demographics
NPI:1538158514
Name:LIN, DANIEL J (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27450 SCHOENHERR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6683
Mailing Address - Country:US
Mailing Address - Phone:586-582-7860
Mailing Address - Fax:586-582-7861
Practice Address - Street 1:27450 SCHOENHERR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6683
Practice Address - Country:US
Practice Address - Phone:586-582-7860
Practice Address - Fax:586-582-7861
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2021-11-10
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Provider Licenses
StateLicense IDTaxonomies
MI4301083046207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2528848OtherUNITED HEALTH CARE
OH2590067Medicaid
OH7519678OtherAETNA
OH04818OtherPARAMOUNT HEALTH CARE
OH412029328030OtherCARESOURCE
OH000000371077OtherBCBS
MI180E011850OtherBCBSM GROUP NUMBER
OH35-0864571OtherOHIO LICENSE
OH731991OtherBUCKEYE
MI4672341Medicaid
MIM92650006Medicare PIN
OH7519678OtherAETNA
OH2528848OtherUNITED HEALTH CARE
MIMI4223001Medicare PIN
OH4168173Medicare PIN
OHP00250825Medicare PIN
OH35-0864571OtherOHIO LICENSE
OH2590067Medicaid
OH000000371077OtherBCBS