Individual
ANDREW LEE-WAH KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-5000
Mailing address
215 N MAIN ST, WHITE RIVER JUNCTION, VT 05009-0001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
042-0011961
VT
2084P0804X
Child & Adolescent Psychiatry Physician
042-0011961
VT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
14590
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017794
—
VT
Enumeration date
09/01/2006
Last updated
08/18/2023
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