Individual
KI BUM LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4713 SAWBUCK ST, ST AUGUSTINE, FL 32092-3690
(904) 940-8993
Mailing address
4713 SAWBUCK ST, ST AUGUSTINE, FL 32092-3690
(904) 940-8993
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD032201L
PA
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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