Basic Information
| Provider Information | |||||||||
| NPI: | 1801945514 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIM | ||||||||
| FirstName: | RIZAL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3725 | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309143725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068639595 | ||||||||
| FaxNumber: | 7068688375 | ||||||||
| Practice Location | |||||||||
| Address1: | 3675 J DEWEY GRAY CIR STE 300 | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309091868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068639595 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 27722 | MS | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | 64606 | TN | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | 0101271594 | VA | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | ME128676 | FL | Y | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | 76383 | GA | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | A137007 | CA | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | DR.0058162 | CO | N | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.