Individual
DR. AMANDA K LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
109 FINNEGAN CT, MYRTLE BEACH, SC 29579-4205
(843) 903-0949
(843) 903-1101
Mailing address
PO BOX 50997, MYRTLE BEACH, SC 29579-0017
(843) 903-0949
(843) 903-1101
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1644
SC
152W00000X
Optometrist
1800
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093HG
BCBS NUMBER
NC
01
—
22-00212
UNITED HEALTHCARE NUMBER
NC
05
—
89093HG
—
NC
Enumeration date
01/12/2006
Last updated
10/01/2012
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