Basic Information
| Provider Information | |||||||||
| NPI: | 1255447959 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIM | ||||||||
| FirstName: | BOON | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178516969 | ||||||||
| Practice Location | |||||||||
| Address1: | 147 GETTYS ST | ||||||||
| Address2: | |||||||||
| City: | GETTYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173252534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173392025 | ||||||||
| FaxNumber: | 7173392011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 11/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D37254 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD435831 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2083P0901X | MD435831 | PA | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine | 208M00000X | MD435831 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 50082107 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 20090433 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 258747 | 01 | PA | UNISON-WMG | OTHER | 018105 | 01 | PA | JOHNS HOPKINS | OTHER | 117611 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 6726533 | 01 | PA | AETNA | OTHER | 102237934 | 05 | PA | MEDICAID | 531317 | 01 | MD | CAREFIRST MD BCBS | OTHER | 689005 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 1550632 | 01 | PA | GATEWAY-WMG | OTHER | 125361101 | 05 | MD | MEDICAID |