Provider Demographics
NPI:1093317976
Name:LIM, DANIEL YOUNGPOONG (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:YOUNGPOONG
Last Name:LIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7081 ARUNDEL MILLS CIR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1387
Mailing Address - Country:US
Mailing Address - Phone:410-579-2953
Mailing Address - Fax:
Practice Address - Street 1:7081 ARUNDEL MILLS CIR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1387
Practice Address - Country:US
Practice Address - Phone:410-579-2953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist