Organization
JAE YOUNG LEE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAE YOUNG LEE MD PC (OWNER)
(810) 765-8844
Entity
Organization
Contact information
Practice address
130 WASHINGTON ST, MARINE CITY, MI 48039-1680
(810) 765-8844
(810) 765-4326
Mailing address
130 WASHINGTON ST, MARINE CITY, MI 48039-1680
(810) 765-8844
(810) 765-4326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301033400
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1068960
—
MI
Enumeration date
05/23/2008
Last updated
12/29/2010
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