Individual
DR. SUSANNE NUSSEN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3805 W CHESTER PIKE BLDG D, SUITE 120, NEWTOWN SQUARE, PA 19073-2329
(800) 257-0117
(610) 550-3079
Mailing address
14275 MIDWAY RD STE 400, ADDISON, TX 75001-3614
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
C1-0008614
DE
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
MD421782
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD421782
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11517014
CAQH
—
Enumeration date
12/16/2005
Last updated
08/17/2022
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