# JAE YOUNG LEE MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811155039
- **Authorized official:** JAE YOUNG LEE MD PC (OWNER)
- **Authorized official phone:** (810) 765-8844

## Contact information

- **Practice address:** 130 WASHINGTON ST, MARINE CITY, MI 48039-1680
- **Practice address phone:** (810) 765-8844
- **Practice address fax:** (810) 765-4326
- **Mailing address:** 130 WASHINGTON ST, MARINE CITY, MI 48039-1680
- **Mailing address phone:** (810) 765-8844
- **Mailing address fax:** (810) 765-4326

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 4301033400 | MI | Yes |

## Other

- **Enumeration date:** 05/23/2008
- **Last updated:** 12/29/2010