Individual
DR. JEN-JAR LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
94-01254
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1177E
BCBS
NC
05
—
1194757633
—
VA
01
—
202035
MEDCOST
NC
05
—
3810009776
—
WV
01
—
5374708
AETNA
—
01
—
810643
PARTNERS
NC
05
—
891177E
—
NC
05
—
Q54094
—
SC
Enumeration date
07/07/2006
Last updated
05/13/2008
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