| Doctor Name: | DR. JOSE DENNIS LIM |
| NPI Number: | 1821082090 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01044250A |
| Business Practice Address: | 1901 W Western Ave #b South Bend, IN - 466193521 |
| Business Phone Number: | 5742349033 |
| Business Fax Number: | 5742349059 |
| Mailing Address: | 69925 Cassopolis Rd, EDWARDSBURG |
| State: | MI |
| Postal Code: | 491129210 |
| Phone Number: | 5743397455 |
| Fax Number: | |
| NPI Enumeration Date: | 09/02/2005 |
| NPI Last Update Date: | 01/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01044250A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |