Healthcare Provider Details

I. General information

NPI: 1871086330
Provider Name (Legal Business Name): KRISTINA MAUREEN LIM DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2018
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5454 WISCONSIN AVE STE 725
CHEVY CHASE MD
20815-6947
US

IV. Provider business mailing address

5454 WISCONSIN AVE STE 725
CHEVY CHASE MD
20815-6947
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-1006
  • Fax: 301-986-1056
Mailing address:
  • Phone: 301-986-1006
  • Fax: 301-986-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberH0102235
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License NumberH0102235
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberH0102235
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: