Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D45573 | MD |
N | 111NI0900X | Internist | D45573 | MD |
Y | 207RR0500X | Rheumatology | MD20695 | DC |
NPI | 1033287487 |
---|---|
Provider Name | Dr. Ivan Y Lim |
First Address | Rockville, MD 20852-4908 |
Second Address | Washington, DC 20002-8100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2006 |
Last Update Date | 22/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P27756 | (02) |