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General NPI Number Information
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NPI Number | 1922369636
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Entity Type | Organization
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Legal Business Name | ASTOR T. LIM, MD, PC
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 3226 HAMPTON AVE SUITE E
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City | BRUNSWICK
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State | GA
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Zip | 31520-4225
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Country | US
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Telephone | 912-265-2343
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Fax | 912-265-7792
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Provider Business Mailing Address
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Address Line | 3226 HAMPTON AVE SUITE E
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City | BRUNSWICK
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State | GA
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Zip | 31520-4225
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Country | US
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Telephone | 912-265-2343
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Fax | 912-265-7792
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Authorized Official
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Title or Position | PRESIDENT
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Name | ASTOR T LIM
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Credential | MD
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Telephone | 912-265-2343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 018819
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License Number State | GA
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