Individual
JONATHAN LEE LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
231 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2694
(919) 235-6560
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019-01706
NC
207R00000X
Internal Medicine Physician
285139
NY
208000000X
Pediatrics Physician
2019-01706
NC
208000000X
Pediatrics Physician
285139
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04502012
—
NY
05
—
1083970156
—
NC
Enumeration date
04/03/2012
Last updated
01/31/2024
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