Mimi Lum

NPI 1407076292 - Optometrist - 152W00000X

NPI Details
NPI 1407076292
Gender Female
Enumeration Date 04/26/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
880 RUSSELL AVE
GAITHERSBURG MD, 20879-3506, US
Phone (301) 556-1973
Fax
Business Location
12517 BRIDGETON DR
POTOMAC MD, 20854-1027, US
Phone
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Maryland
License Number TA1990
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According to our database, Dr. Mimi Lum NPI is 1407076292, taxonomy code is 152W00000X and license number is TA1990, license state is located at Maryland. Mimi Lum physically located at 880 Russell Ave, Gaithersburg MD, 20879-3506. NPI Number Mimi Lum has the Individual type.

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1407076292 NPI number is provided on an as is basis without warranty of any kind. 1407076292 is maintained by the National Plan & Provider Enumeration System. The contents of Mimi Lum are for informational purposes only.