Provider Demographics
NPI:1063513810
Name:YUH, SONG-LIM (MD)
Entity type:Individual
Prefix:DR
First Name:SONG-LIM
Middle Name:
Last Name:YUH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 E45 #236
Mailing Address - Street 2:#2
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44127-1091
Mailing Address - Country:US
Mailing Address - Phone:216-303-9693
Mailing Address - Fax:216-341-3470
Practice Address - Street 1:3100 E45 #236
Practice Address - Street 2:#2
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1091
Practice Address - Country:US
Practice Address - Phone:216-303-9693
Practice Address - Fax:216-341-3470
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042317208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0373475Medicaid
OH0373475Medicaid
OH0563242Medicare ID - Type Unspecified