Individual
LINDA MARY DALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1516 23RD AVE, MERIDIAN, MS 39301-4026
(601) 703-3820
(601) 703-0125
Mailing address
1516 23RD AVE, MERIDIAN, MS 39301-4026
(601) 703-3820
(601) 703-0125
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
200000203
NC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
21644
MS
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
30413
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00358088
—
MS
01
—
12700
BCBSNC
NC
01
—
188453
MEDCOST
NC
01
—
2119923
CIGNA HEALTHCARE
NC
05
—
304138
—
SC
05
—
8912700
—
NC
05
—
GP4505
—
SC
01
—
P00326699
RAILROAD MEDICARE
NC
Enumeration date
05/26/2006
Last updated
11/12/2012
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