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Individual

PENGXIN LIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4701 RANDOLPH ROAD, SUITE 102, ROCKVILLE, MD 20852-2260
(301) 881-6651
(301) 881-6653
Mailing address
4701 RANDOLPH RD, SUITE 102, ROCKVILLE, MD 20852-2257
(301) 881-6651
(301) 881-6653

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0058236
MD
208U00000X
Clinical Pharmacology Physician
D0058236
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12-06189
UNITED HEALTH CARE
MD
01
120631
JOHNS HOPKINS HEALTH CARE
MD
01
146804160
AMERIGROUP MEDICAID
MD
01
3543954
AETNA--HMO
MD
05
401615700
MD
01
618642-02
BC/BS MARYLAND
MD
01
653547
NCPPO
MD
01
7691425
AETNA STUDENT MC N
MD
01
7870575
AETNA-PPO
MD
01
8127281
MAMSI
MD
01
K143-0002
BC/BS DC AND FEDERAL
MD
01
P16571
BC/BS POS
MD
Enumeration date
10/24/2005
Last updated
11/22/2011
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