Individual
YOUNG J LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 COLLIERS WAY, WEIRTON, WV 26062-5014
(304) 797-6000
Mailing address
101 CHERRINGTON CT, CORAOPOLIS, PA 15108-9756
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12953
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000144640
MT STATE BCBS
WV
05
—
0119218000
—
WV
05
—
0507526
—
OH
01
—
12953
HEALTH PLAN OF UPPER OH V
—
01
—
P00191582
RAILROAD MEDICARE
WV
Enumeration date
03/07/2006
Last updated
10/16/2007
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