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General NPI Number Information
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NPI Number | 1811152945
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Entity Type | Organization
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Legal Business Name | MICHAEL G. LIM, MD
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 2402 W PIERCE ST STE 1B
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City | CARLSBAD
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State | NM
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Zip | 88220
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Country | US
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Telephone | 575-887-5325
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Fax | 575-887-6449
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Provider Business Mailing Address
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Address Line | 2402 W PIERCE ST STE 1B
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City | CARLSBAD
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State | NM
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Zip | 88220-3568
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Country | US
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Telephone | 575-887-5325
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Fax | 575-887-6449
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MICHAEL G LIM
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Credential | MD
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Telephone | 575-887-5325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 93-313
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License Number State | NM
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