Individual
EUI-DONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
404 HAZEN ST, SUITE 101, PAW PAW, MI 49079-1040
(269) 657-4407
(269) 657-0965
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7806
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301032196
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104994926
—
MI
05
—
1861479891
—
MI
01
—
700H060020
BCBSM
MI
Enumeration date
12/30/2005
Last updated
09/16/2009
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