Individual
DR. EDWARD STEPHEN LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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