Provider Demographics
NPI:1780655480
Name:LIM, FELIXBERTO D (MD)
Entity Type:Individual
Prefix:
First Name:FELIXBERTO
Middle Name:D
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OAKBROOK DR
Mailing Address - Street 2:SUITE 2201
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6403
Mailing Address - Country:US
Mailing Address - Phone:724-834-1463
Mailing Address - Fax:724-834-1464
Practice Address - Street 1:400 OAKBROOK DR
Practice Address - Street 2:SUITE 2201
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6403
Practice Address - Country:US
Practice Address - Phone:724-834-1463
Practice Address - Fax:724-834-1464
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037367E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA600783Medicare ID - Type Unspecified
PAC66795Medicare UPIN