Provider Demographics
NPI:1770878993
Name:LIM, JOSHUA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
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 16
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-0016
Mailing Address - Country:US
Mailing Address - Phone:240-200-5801
Mailing Address - Fax:
Practice Address - Street 1:7500 GREENWAY CENTER DR STE 480
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3568
Practice Address - Country:US
Practice Address - Phone:240-200-5801
Practice Address - Fax:240-200-5802
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101283516207T00000X
MDD87302207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery