Provider Demographics
NPI:1366558744
Name:LIM, SUNG SAM (MD, MPH)
Entity type:Individual
Prefix:
First Name:SUNG
Middle Name:SAM
Last Name:LIM
Suffix:
Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:49 JESSE HILL JR DR SE
Mailing Address - Street 2:RHEUMATOLOGY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49 JESSE HILL JR DR SE
Practice Address - Street 2:RHEUMATOLOGY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3049
Practice Address - Country:US
Practice Address - Phone:404-616-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA046156207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG32268Medicare UPIN