Provider Demographics
NPI:1124024112
Name:LIM, CHANG S (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANG
Middle Name:S
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 602381
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2381
Mailing Address - Country:US
Mailing Address - Phone:828-274-6000
Mailing Address - Fax:828-274-6025
Practice Address - Street 1:5 VANDERBILT PARK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1700
Practice Address - Country:US
Practice Address - Phone:828-274-6000
Practice Address - Fax:828-274-6025
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9600613207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG26468Medicare UPIN
NC891263XMedicaid
2223531CMedicare PIN
NC2223531AMedicare ID - Type Unspecified