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
—
—
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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