Provider Demographics
NPI:1902887573
Name:DINERMAN, LINDA M (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:DINERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:420 LOWELL DRIVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-535-5940
Mailing Address - Fax:256-535-5954
Practice Address - Street 1:116 LILY FLAGG RD SW
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-3066
Practice Address - Country:US
Practice Address - Phone:256-883-1110
Practice Address - Fax:256-883-1114
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2010-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL24103207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51505321OtherBLUE CROSS BLUE SHIELD
631284727OtherTAX ID
0005005203OtherAETNA
631284727OtherTAX ID