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General NPI Number Information
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NPI Number | 1386870459
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Entity Type | Organization
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Legal Business Name | NELSON H. LIM MD, LLC
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 2563 S VAL VISTA DR STE 101
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City | GILBERT
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State | AZ
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Zip | 85295-1804
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Country | US
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Telephone | 480-722-9788
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Fax | 480-722-9789
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Provider Business Mailing Address
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Address Line | 2563 S VAL VISTA DR STE 101
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City | GILBERT
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State | AZ
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Zip | 85295-1804
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Country | US
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Telephone | 480-722-9788
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Fax | 480-722-9789
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Authorized Official
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Title or Position | OWNERPHYSICIAN
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Name | DR. NELSON H LIM
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Credential | MD
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Telephone | 480-722-9788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 42036
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License Number State | AZ
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