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Organization

PREMIER CARDIOTHORACIC AND VASCULAR SURGEONS INC

Active
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Organization

PREMIER CARDIOTHORACIC AND VASCULAR SURGEONS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KOK H LIM MD (PRESIDENT)
(937) 275-5100
Entity
Organization

Contact information

Practice address
30 E APPLE ST STE 6200, DAYTON, OH 45409-2939
(937) 275-5100
(937) 275-4587
Mailing address
PO BOX 73392, CLEVELAND, OH 44193-0002
(937) 293-0247
(937) 293-0960

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000039029
ANTHEM
OH
05
—
2149946
—
OH
01
—
DB6525
RAILROAD MEDICARE
OH
Enumeration date
05/28/2006
Last updated
08/15/2018
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