Individual
JEON W LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1414 W FAIR AVE, SUITE 211, MARQUETTE, MI 49855-2675
(906) 225-3912
(906) 225-7538
Mailing address
4602 DEPARTMENT, CAROL STREAM, IL 60122-0021
(906) 225-4821
(906) 225-4537
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
070506
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290014109
RAILROAD MEDICARE
MI
05
—
4334943
—
MI
Enumeration date
09/21/2006
Last updated
04/21/2009
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