Provider Demographics
NPI:1023004355
Name:LIM, TIMPLE WEE (MD PHD)
Entity Type:Individual
Prefix:
First Name:TIMPLE
Middle Name:WEE
Last Name:LIM
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N WILSON DR
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1560
Mailing Address - Country:US
Mailing Address - Phone:937-544-2418
Mailing Address - Fax:937-544-5388
Practice Address - Street 1:107 N WILSON DR
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1560
Practice Address - Country:US
Practice Address - Phone:937-544-2418
Practice Address - Fax:937-544-5388
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350391040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0315706Medicaid
C01433Medicare UPIN
OHLI0432241Medicare ID - Type Unspecified