Provider Demographics
NPI:1154579043
Name:LIM, ANDREW S (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 RANLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M4N1X2
Mailing Address - Country:CA
Mailing Address - Phone:416-838-4060
Mailing Address - Fax:
Practice Address - Street 1:2075 BAYVIEW AVENUE
Practice Address - Street 2:M1-600
Practice Address - City:TORONTO
Practice Address - State:ONTARIO
Practice Address - Zip Code:M4N3M5
Practice Address - Country:CA
Practice Address - Phone:416-480-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2349342084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine