Individual
HO KYU LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 SAINT ANTOINE ST, DRH 3L-8, DETROIT, MI 48201-2153
(313) 745-3430
(313) 577-8600
Mailing address
1420 STEPHENSON HWY, TROY, MI 48083-1189
(313) 745-3430
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
SP-158
IA
2085R0202X
Diagnostic Radiology Physician
Primary
4301091185
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0439190
—
IA
01
—
36327
WELLMARK BCBS
IA
Enumeration date
10/28/2005
Last updated
05/04/2012
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