Basic Information
| Provider Information | |||||||||
| NPI: | 1528262193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIN | ||||||||
| FirstName: | XI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3421 CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173392790 | ||||||||
| FaxNumber: | 7173392791 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 V-TWIN DR | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | GETTYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173257878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173392790 | ||||||||
| FaxNumber: | 7173392791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2007 | ||||||||
| LastUpdateDate: | 07/21/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 41790 | TX | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | MD436925 | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 929254 | 01 | MD | CAREFIRST MD BCBS | OTHER | C15830 | 01 | RAILROAD MEDICARE GROUP # | OTHER | 00R518 | 01 | MEDICARE GROUP # | OTHER | 102300573 | 05 | PA | MEDICAID | 2109656 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 1582869 | 01 | PA | GATEWAY-WMG | OTHER | 20091170 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 272711 | 01 | PA | UNISON-WMG | OTHER |