Healthcare Provider Details

I. General information

NPI: 1861459935
Provider Name (Legal Business Name): LUKE LIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 LOCKWOOD DRIVE STE 200
SILVER SPRING MD
20901
US

IV. Provider business mailing address

10 COMMERCE DRIVE
NEW ROCHELLE NY
10801-5214
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-2255
  • Fax: 914-819-0061
Mailing address:
  • Phone: 914-637-2063
  • Fax: 914-819-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number26849
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: