Provider Demographics
NPI:1659336782
Name:OCAMPO-LIM, BLANCA N (MD)
Entity Type:Individual
Prefix:MRS
First Name:BLANCA
Middle Name:N
Last Name:OCAMPO-LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 DEAK DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-1268
Mailing Address - Country:US
Mailing Address - Phone:302-261-5600
Mailing Address - Fax:302-653-9563
Practice Address - Street 1:38 DEAK DR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1268
Practice Address - Country:US
Practice Address - Phone:302-261-5600
Practice Address - Fax:302-653-9563
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0005633207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001050301Medicaid
G02222OtherMEDICARE