Basic Information
| Provider Information | |||||||||
| NPI: | 1548822588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIM | ||||||||
| FirstName: | JOSEPH MICHAEL LE | ||||||||
| MiddleName: | ESTENZO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8701 WATERTOWN PLANK RD | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532263548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4149557042 | ||||||||
| FaxNumber: | 4149550093 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 AKRON GENERAL AVE | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443072432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303446000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2019 | ||||||||
| LastUpdateDate: | 04/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 57.247165 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 76789-20 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No ID Information.