Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2011015242 | MO |
Y | 2080P0214X | Pediatric Pulmonologist | 41075 | SC |
NPI | 1497043632 |
---|---|
Provider Name | Dr. Chung Albert Lee |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2011 |
Last Update Date | 17/03/2018 |