Provider Demographics
NPI:1295756518
Name:TRAN-LIM, TERESA ANH (MD)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:ANH
Last Name:TRAN-LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:AHN
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3931 LOUISIANA AVE S
Mailing Address - Street 2:SUITE E500
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4375
Mailing Address - Country:US
Mailing Address - Phone:952-993-3200
Mailing Address - Fax:952-993-2701
Practice Address - Street 1:6490 EXCELSIOR BLVD
Practice Address - Street 2:SUITE E500
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4705
Practice Address - Country:US
Practice Address - Phone:952-993-3200
Practice Address - Fax:952-993-2701
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN424622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
05-81570OtherMEDICA
01014964OtherPREFERRED ONE
130021476OtherRAILROAD MEDICARE
A016OtherTRIWEST
MN47B98TROtherBLUE CROSS BLUE SHIELD
HP37171OtherHEALTHPARTNERS
41-1677590OtherWEA TRUST INSURANCE
41-1677590Other1ST CHOICE OF THE MIDWEST
975338OtherAMERICAS PPO
MN088495200Medicaid
ND10088Medicaid
975338OtherAMERICAS PPO
F64510Medicare UPIN