Doctor Name: | DR. AGNES LIM |
NPI Number: | 1639449184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | G063747 |
Business Practice Address: | 8104 Maple Ridge Rd Bethesda, MD - 208141359 |
Business Phone Number: | 3016526068 |
Business Fax Number: | |
Mailing Address: | 8104 Maple Ridge Rd, BETHESDA |
State: | MD |
Postal Code: | 208141359 |
Phone Number: | 3016526068 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2011 |
NPI Last Update Date: | 12/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G063747 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |