Individual
PAULA LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54937-6725
(920) 923-0788
(920) 686-9674
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
52686-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942344346
—
WI
01
—
382000012
MEDICARE
WI
01
—
52686-020
STATE LICENSE
WI
01
—
P00714750
RAILROAD MEDICARE
WI
Enumeration date
02/18/2007
Last updated
03/07/2023
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