Individual
LORENZO RAY MATA LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
23077 GREENFIELD RD STE 195, SOUTHFIELD, MI 48075-3750
(248) 423-0700
(248) 423-0707
Mailing address
23077 GREENFIELD RD STE 195, SOUTHFIELD, MI 48075-3750
(248) 423-0700
(248) 423-0707
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101021830
MI
Other
Enumeration date
05/27/2015
Last updated
10/03/2018
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