Individual
JONATHAN BUM LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7101 JAHNKE RD, RICHMOND, VA 23225-4044
(954) 977-9068
Mailing address
505 PORTER ST APT 807, RICHMOND, VA 23224-2321
(703) 868-3787
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
1215356514
VA
208000000X
Pediatrics Physician
1215356514
VA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
1215356514
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2014
Last updated
06/30/2021
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