Provider Demographics
NPI:1871660936
Name:LIMOVA, MARKETA (MD)
Entity Type:Individual
Prefix:
First Name:MARKETA
Middle Name:
Last Name:LIMOVA
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 1:346 W AUDUBON DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-6095
Mailing Address - Country:US
Mailing Address - Phone:559-438-6577
Mailing Address - Fax:559-438-0585
Practice Address - Street 1:1340 W HERNDON AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-7180
Practice Address - Country:US
Practice Address - Phone:559-438-6577
Practice Address - Fax:559-438-0585
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG64053207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF07391Medicare UPIN