Provider Demographics
NPI:1023270592
Name:SIM, BICH-THUY THI (MD)
Entity type:Individual
Prefix:DR
First Name:BICH-THUY
Middle Name:THI
Last Name:SIM
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 1:1125 N MAIN ST
Mailing Address - Street 2:IMMUNOLOGY CLINIC
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5739
Mailing Address - Country:US
Mailing Address - Phone:401-793-2928
Mailing Address - Fax:401-793-7401
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:PARKINSON PAVILLION, 8TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-363-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190978207R00000X
RIMD13406207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICMD13406OtherRI STATE MEDICAL BOARD
PAMT190978OtherPENNSYLVANIA MEDICAL TRAINING LICENSE
RIMD13406OtherRI STATE MEDICAL BOARD