Individual
JUNG SOOK LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1786C COLUMBIA AVE, COLUMBIA, PA 17512-9508
(717) 684-3663
(717) 684-9030
Mailing address
409 S 2ND ST STE 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD037840L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000654210
—
PA
Enumeration date
07/19/2006
Last updated
11/10/2017
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