Provider Demographics
NPI:1992749808
Name:LE, LINH T (MD)
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:T
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7203 RUDCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-8963
Mailing Address - Country:US
Mailing Address - Phone:573-808-7812
Mailing Address - Fax:
Practice Address - Street 1:7203 RUDCHESTER CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-8963
Practice Address - Country:US
Practice Address - Phone:573-808-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017037821207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1992749808Medicaid
7608123OtherAETNA
1599034OtherUNISYS
LA1599034Medicaid
8G2567OtherBCBS
TX043095102Medicaid
10012727OtherAMERIGROUP
110236778OtherMEDICARE RAILROAD
TX8105B6OtherBLUE CROSS BLUE SHEILD
8G2567OtherANTHEM
TX043095102Medicaid