Provider Demographics
NPI:1003911165
Name:LIM, MIRANDA MING-WAI (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRANDA
Middle Name:MING-WAI
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3624 MARKET STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2614
Mailing Address - Country:US
Mailing Address - Phone:215-662-7772
Mailing Address - Fax:215-349-8038
Practice Address - Street 1:3624 MARKET STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2614
Practice Address - Country:US
Practice Address - Phone:215-662-7772
Practice Address - Fax:215-349-8038
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20060179012084N0400X
PAMD4418252084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology