Individual
DR. JUSTIN BLAKE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 CABELA DR, TRIADELPHIA, WV 26059-1044
(681) 618-1011
Mailing address
500 CABELA DR, TRIADELPHIA, WV 26059-1044
(681) 618-1011
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
32512
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2021
Last updated
07/02/2025
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