Provider Demographics
NPI:1124025317
Name:LIM, ELIZABETH G (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SHADY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4316
Mailing Address - Country:US
Mailing Address - Phone:412-661-1800
Mailing Address - Fax:412-661-6520
Practice Address - Street 1:250 SHADY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4316
Practice Address - Country:US
Practice Address - Phone:412-661-1800
Practice Address - Fax:412-661-6520
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031683E207RC0000X, 207RA0401X
OH35075638L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2106410Medicaid
WV0991001000Medicaid
PA0010596010006Medicaid
OHLI0871232Medicare PIN
PA0010596010006Medicaid
OH0871237Medicare PIN
PA474541PK7Medicare PIN