Provider Demographics
NPI:1821053992
Name:HO-A-LIM, FRED (MD)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:
Last Name:HO-A-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 1:3621 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1512
Mailing Address - Country:US
Mailing Address - Phone:419-474-4942
Mailing Address - Fax:419-472-8035
Practice Address - Street 1:3621 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1512
Practice Address - Country:US
Practice Address - Phone:419-474-4942
Practice Address - Fax:419-472-8035
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-055690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0681918Medicaid
OHHO4026512Medicare ID - Type Unspecified
OHC03284Medicare UPIN