Individual
SU-JU LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
234 GOODMAN AVENUE, CINCINNATI, OH 45219
(513) 584-5335
(513) 584-3663
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3107
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35058343L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0864015
—
OH
05
—
100211910
—
IN
05
—
64875330
—
KY
Enumeration date
08/02/2005
Last updated
04/22/2020
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