MEDICARE: W. LIMA, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D23262	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	5407	OTHER	MD	MEDICARE PTEN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1982677688	OTHER	MD	NPI

General Provider Information

NPI Number	:	1558709345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W. LIMA, M.D., P.A.

Provider Business Mailing Address
First Line	:	1905 YORK RD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-4224
Country	:	US
Telephone Number	:	410-561-2424
Fax Number	:	410-252-1342

Provider Business Practice Location Address
First Line	:	1905 YORK RD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-4224
Country	:	US
Telephone Number	:	410-561-2424
Fax Number	:	410-252-1342

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WEERASAK W. LIMA
Credential	:	M.D.
Telephone Number	:	410-561-2424

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	06/13/2013

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