1952966103 NPI number — DR. WILLIAM LIM MD

Table of content: DR. WILLIAM LIM MD (NPI 1952966103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952966103 NPI number — DR. WILLIAM LIM MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIM
Provider First Name:
WILLIAM
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KYAW
Provider Other First Name:
WAI
Provider Other Middle Name:
HIN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1952966103
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 S BALLENGER HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48532-3638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-342-2000
Provider Business Mailing Address Fax Number:
810-342-3659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 S BALLENGER HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532-3638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-342-2000
Provider Business Practice Location Address Fax Number:
810-342-3659
Provider Enumeration Date:
05/02/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , with the licence number: 4301506630 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)