Provider Demographics
NPI:1760480164
Name:LIM, HYUNG MIN (MD)
Entity Type:Individual
Prefix:
First Name:HYUNG
Middle Name:MIN
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5601 LOCH RAVEN BLVD
Mailing Address - Street 2:STE 3
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2905
Mailing Address - Country:US
Mailing Address - Phone:443-444-3775
Mailing Address - Fax:443-444-4678
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:STE 312
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4463
Practice Address - Country:US
Practice Address - Phone:443-444-3775
Practice Address - Fax:443-444-4678
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2010-05-19
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Provider Licenses
StateLicense IDTaxonomies
MDD0046907207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD54234901OtherBLUE SHIELD
MD19300300Medicaid
MD19300300Medicaid