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Individual

JEONG MIN LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3375
(319) 356-2220
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-3375
(319) 356-2220

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
SP184
IA
2085R0202X
Diagnostic Radiology Physician
SP184
IA
2085R0204X
Vascular & Interventional Radiology Physician
SP184
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55975
WELLMARK BCBS
IA
Enumeration date
08/01/2007
Last updated
12/14/2007
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