Provider Demographics
NPI:1174596993
Name:LIM, PAUL K (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:K
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 UNIVERSITY AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2507
Mailing Address - Country:US
Mailing Address - Phone:651-578-5197
Mailing Address - Fax:651-312-3188
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-578-5197
Practice Address - Fax:651-312-3188
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2013-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN472312086S0122X
WI47604-0202086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN540657900Medicaid
MN540657900Medicaid
G49526Medicare UPIN