Provider Demographics
NPI:1497931836
Name:LIM, MICHAEL QUE (MD)
Entity Type:Individual
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First Name:MICHAEL
Middle Name:QUE
Last Name:LIM
Suffix:
Gender:M
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:301-576-7208
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 209
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-825-7000
Practice Address - Fax:410-821-7008
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2023-11-02
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Provider Licenses
StateLicense IDTaxonomies
MDD0066938207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD419037800Medicaid