Provider Demographics
NPI:1568925592
Name:LIM, MARIA VICTORIA ROSARIO PACANA (PA-C)
Entity Type:Individual
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First Name:MARIA VICTORIA
Middle Name:ROSARIO PACANA
Last Name:LIM
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1774 METROMEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1774 METROMEDICAL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3861
Practice Address - Country:US
Practice Address - Phone:910-568-3903
Practice Address - Fax:910-568-3908
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
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Provider Licenses
StateLicense IDTaxonomies
NC001008827363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant