Provider Demographics
NPI:1871587998
Name:LIM, RUTH T (MD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:T
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2058 S DOBSON RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6454
Mailing Address - Country:US
Mailing Address - Phone:480-820-4507
Mailing Address - Fax:480-491-2439
Practice Address - Street 1:2058 S DOBSON RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6454
Practice Address - Country:US
Practice Address - Phone:480-820-4507
Practice Address - Fax:480-491-2439
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2020-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZAZ 10737208000000X
AZAZ10737208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ10737OtherARIZONA STATE LICENSE NUM