Provider Demographics
NPI:1386863520
Name:LIM, SARAH (MBBCH)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:MBBCH
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBCH
Mailing Address - Street 1:625 ROBERT ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55155-2538
Mailing Address - Country:US
Mailing Address - Phone:651-201-5414
Mailing Address - Fax:651-201-5743
Practice Address - Street 1:625 ROBERT ST N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55155-2538
Practice Address - Country:US
Practice Address - Phone:651-201-5414
Practice Address - Fax:651-201-5743
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420012452207RI0200X
MN66268207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease