Provider Demographics
NPI:1780611103
Name:LIM, ARNOLD A (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:A
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7080 N PORT WASHINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217
Mailing Address - Country:US
Mailing Address - Phone:414-351-4009
Mailing Address - Fax:414-351-7060
Practice Address - Street 1:7080 N PORT WASHINGTON ROAD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217
Practice Address - Country:US
Practice Address - Phone:414-351-4009
Practice Address - Fax:414-351-7060
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI53772207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00941481OtherRR MEDICARE
WI019940428Medicare PIN
WI462360663Medicare PIN
WIP00941481OtherRR MEDICARE