Individual
DR. EDWARD STEPHEN LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
144 N MAIN ST, BRANFORD, CT 06405-3044
(203) 643-0270
(203) 488-1104
Mailing address
144 N MAIN ST, BRANFORD, CT 06405-3044
(203) 643-0270
(203) 488-1104
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
033710
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001337105
—
CT
01
—
010033710CT09
ANTHEM
CT
01
—
180034796
MC
CT
01
—
D400003711
MEDICARE PTAN
CT
Enumeration date
01/31/2006
Last updated
01/27/2010
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