Provider Demographics
NPI:1669401642
Name:LIM, MENG L (MD)
Entity type:Individual
Prefix:DR
First Name:MENG
Middle Name:L
Last Name: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:PO BOX 211279
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-0399
Mailing Address - Country:US
Mailing Address - Phone:303-427-0648
Mailing Address - Fax:303-427-0433
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:STE 160
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-679-8900
Practice Address - Fax:970-679-8915
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO226202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01226208Medicaid
D24136Medicare UPIN
COCA3818Medicare ID - Type Unspecified
COC430818Medicare ID - Type Unspecified