Provider Demographics
NPI:1528044146
Name:LIM, SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2877 CROOKS RD
Mailing Address - Street 2:STE B
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4717
Mailing Address - Country:US
Mailing Address - Phone:248-822-7003
Mailing Address - Fax:248-822-7008
Practice Address - Street 1:2877 CROOKS RD
Practice Address - Street 2:STE B
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4717
Practice Address - Country:US
Practice Address - Phone:248-822-7003
Practice Address - Fax:248-822-7008
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-07-28
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Provider Licenses
StateLicense IDTaxonomies
MI4301076664207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I20488Medicare UPIN
OP02090Medicare ID - Type Unspecified