Lim, Custodio L.
Lim, Custodio L. is an sole proprietor health care provider with primary practice located at 2235 Wabash Ave , Terre Haute IN 47807-3330. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Lim, Custodio L. can be contacted via phone (812) 234-5273.Contact Information
Primary practice address
2235 Wabash Ave
Terre Haute IN 47807-3330
Phone: (812) 234-5273
Fax: (812) 232-4714
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01035522 | Indiana |
Profile Details
| NPI number | 1063404259 |
|---|---|
| LBN Legal business name | Lim, Custodio L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Sep 15th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063404259 | NPPES |
| Indiana | MEDICAID | 100251710A | |
| Indiana | Other | 000000087131 |
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