Individual
EUGENE LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2421 LAPORTE AVE, VALPARAISO, IN 46383-6914
(219) 462-6914
(219) 462-0426
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01048941A
IN
208000000X
Pediatrics Physician
01048941A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000721916
ANTHEM TRADITIONAL
IN
05
—
200224900
—
IN
Enumeration date
08/18/2005
Last updated
05/30/2023
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