Provider Demographics
NPI:1144307711
Name:THOMPSON, M LINDA M (MD)
Entity type:Individual
Prefix:DR
First Name:M LINDA
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5823 CONWAY RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817
Mailing Address - Country:US
Mailing Address - Phone:301-256-4766
Mailing Address - Fax:301-652-4888
Practice Address - Street 1:8218 WISCONSIN AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3107
Practice Address - Country:US
Practice Address - Phone:301-652-5454
Practice Address - Fax:301-652-4888
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83603Medicare UPIN
MD492034Medicare ID - Type Unspecified