Individual
JANGWOO LEE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 W MARKET AND CENTER ST, THOMPSON BLDG, STE 311, POTTSVILLE, PA 17901
(570) 628-5625
(570) 628-0393
Mailing address
101 W MARKET AND CENTER ST, THOMPSON BLDG, STE 311, POTTSVILLE, PA 17901
(570) 628-5625
(570) 628-0393
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD033378L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006087630001
—
PA
01
—
02337000
BLUE CROSS
PA
01
—
15969
GEISINGER
PA
Enumeration date
08/02/2005
Last updated
07/08/2007
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