Individual
LINDA MARIE STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-4959
Mailing address
3624 J DEWEY GRAY CIR STE 308, AUGUSTA, GA 30909-6580
(706) 922-7670
(706) 863-8175
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
32026
SC
207V00000X
Obstetrics & Gynecology Physician
75544
GA
207VM0101X
Maternal & Fetal Medicine Physician
2013-00501
NC
207VM0101X
Maternal & Fetal Medicine Physician
32026
SC
207VM0101X
Maternal & Fetal Medicine Physician
Primary
75544
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179TK
BCBS
NC
05
—
1962630830
—
NC
01
—
5632783
AETNA
NC
Enumeration date
06/30/2009
Last updated
01/07/2022
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