Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | DR.0062048 | CO |
Y | 207ND0101X | MOHS-Micrographic Surgeon | DR.0062048 | CO |
NPI | 1013335751 |
---|---|
Provider Name | Dr. Geoffrey Fung-Soon Lim |
First Address | Colorado Springs, CO 80907-5700 |
Second Address | Colorado Springs, CO 80907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 15/08/2019 |