Individual
DAEWOONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
888 S AUTO MALL RD, BLOOMINGTON, IN 47401-5430
(812) 353-2700
(812) 353-2701
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
270737
MA
207R00000X
Internal Medicine Physician
125.069028
IL
208VP0000X
Pain Medicine Physician
66702
MN
208VP0014X
Interventional Pain Medicine Physician
Primary
01086201A
IN
Other
Enumeration date
05/05/2016
Last updated
01/07/2022
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