Provider Demographics
NPI:1265722862
Name:LIM, MARIA EMMELINE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:EMMELINE
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:608 STANTON L YOUNG BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5065
Mailing Address - Country:US
Mailing Address - Phone:405-271-6060
Mailing Address - Fax:405-271-1926
Practice Address - Street 1:608 STANTON L YOUNG BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-1094
Practice Address - Fax:405-271-3013
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2020-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK32771207W00000X, 207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200705310AMedicaid