Provider Demographics
NPI:1477629392
Name:LIM, JOANNE QUE (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:QUE
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:7505 OSTER DRIVE
Practice Address - Street 2:209
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-825-7000
Practice Address - Fax:410-821-7008
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2023-11-02
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Provider Licenses
StateLicense IDTaxonomies
MDD0059567207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I0648IMedicare UPIN
2195Medicare ID - Type Unspecified