Active NPI
Mamie Wong-Lim, M.D.
- Internal Medicine Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 071383
- Practice address
- Henry Ford Health System
3031 West Grand Blvd.
Detroit, MI 48202 - Phone
- (313) 916-2454
- NPI assigned
- Dec 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 071383 | MI | Primary |
Addresses
Primary practice location
Henry Ford Health System
3031 West Grand Blvd.
Detroit, MI 48202
Mailing address
Henry Ford Health System
3031 West Grand Blvd.
Detroit, MI 48202
Phone (313) 916-2454
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MW071383 | Other | COMMERCIAL-COMMERCIAL NUMBER | |
| MW071383 | Other | CHAMPUS-CHAMPUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071383 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Internal Medicine | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients |
Locations
1 Ford Pl
#2E
Detroit, MI 48202
Phone (313) 874-4688
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
3031 W Grand Blvd
Detroit, MI 48202
Phone (313) 871-3751
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1891702833
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235207770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HENRY FORD HEALTH SYSTEM",
"address_2": "3031 WEST GRAND BLVD.",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-916-2454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HENRY FORD HEALTH SYSTEM",
"address_2": "3031 WEST GRAND BLVD.",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-916-2454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG-LIM",
"first_name": "MAMIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "071383",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL-COMMERCIAL NUMBER",
"identifier": "MW071383",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS-CHAMPUS",
"identifier": "MW071383",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.