Individual
DR. TIDA KUMBALASIRI LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1000 BRABHAM AVE, JACKSONVILLE, NC 28546-5003
(910) 937-2570
(910) 219-1270
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 617-6705
(910) 431-4048
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
0101248380
VA
207RI0200X
Infectious Disease Physician
Primary
2022-02736
NC
Other
Enumeration date
06/30/2009
Last updated
12/07/2022
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