Individual
JONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5315 ELLIOTT DR STE 304, YPSILANTI, MI 48197-8634
(734) 712-0655
(734) 712-0611
Mailing address
24 FRANK LLOYD WRIGHT DR LBBY J2000, ANN ARBOR, MI 48105-9484
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301094671
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
4301094671
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0727396
—
IA
Enumeration date
01/05/2007
Last updated
05/06/2021
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