Provider Demographics
NPI:1881628121
Name:LIM, SHERI DAVIS (DO)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:DAVIS
Last Name:LIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:SUE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:624 QUAKER LANE
Mailing Address - Street 2:STE 100-C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262
Mailing Address - Country:US
Mailing Address - Phone:336-878-6027
Mailing Address - Fax:336-878-6189
Practice Address - Street 1:601 N ELM ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4331
Practice Address - Country:US
Practice Address - Phone:336-878-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201486207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
14147OtherBLUE CROSS BLUE SHIELD
NC89133UGMedicaid
14147OtherBLUE CROSS BLUE SHIELD
2400080Medicare ID - Type Unspecified