Individual
JIN SOO LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7001 HERITAGE VILLAGE PLZ STE 170, GAINESVILLE, VA 20155
(703) 468-2205
(703) 468-2216
Mailing address
7001 HERITAGE VILLAGE PLZ, SUITE 170, GAINESVILLE, VA 20155
(703) 468-2205
(703) 468-2216
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0101236105
VA
207Y00000X
Otolaryngology Physician
Primary
010123615
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010082889
—
VA
Enumeration date
04/11/2007
Last updated
05/30/2018
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