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Individual

ANDY PO-CHANG LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
98-1079 MOANALUA RD, AIEA, HI 96701-4713
(808) 485-4300
Mailing address
95-1085 INANA ST, MILILANI, HI 96789-6597
(808) 779-5460

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD12345
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A003
CHAMPUS
HI
01
A019
CHAMPUS
HI
Enumeration date
07/05/2006
Last updated
07/08/2007
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