Individual
CHARLES TUAN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHARMD
Contact information
Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0027
(570) 808-7075
(570) 808-6174
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT215436
PA
2085R0001X
Radiation Oncology Physician
Primary
MD479202
PA
2085R0001X
Radiation Oncology Physician
MT215436
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT215436
PENNSYLVANIA GRADUATE MEDICAL TRAINEE LICENSE
PA
Enumeration date
06/11/2018
Last updated
10/20/2023
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