Provider Demographics
NPI:1811424005
Name:LIM, CHRISTOPHER (BMBS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:BMBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 TREMONT ST, ONE BRIGHAM CIRCLE
Mailing Address - Street 2:RADIOLOGY ADMINISTRATION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120
Mailing Address - Country:US
Mailing Address - Phone:617-732-8098
Mailing Address - Fax:617-525-7333
Practice Address - Street 1:1620 TREMONT ST, ONE BRIGHAM CIRCLE
Practice Address - Street 2:RADIOLOGY ADMINISTRATION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120
Practice Address - Country:US
Practice Address - Phone:617-732-8098
Practice Address - Fax:617-525-7333
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2017-12-28
Deactivation Date:2017-12-20
Deactivation Code:
Reactivation Date:2017-12-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program