Provider Demographics
NPI:1578563037
Name:LIM, ANDREW K (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:K
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:925 SENECA ST
Mailing Address - Street 2:G2-GHC GROUP HEALTH AT VIRGINIA MASON
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2742
Mailing Address - Country:US
Mailing Address - Phone:206-341-0736
Mailing Address - Fax:
Practice Address - Street 1:925 SENECA ST
Practice Address - Street 2:G2-GHC GROUP HEALTH AT VIRGINIA MASON
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2742
Practice Address - Country:US
Practice Address - Phone:206-341-0736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79353207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3132455Medicaid
F58924Medicare UPIN
MALI J14727Medicare ID - Type Unspecified