Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 19935 | NC |
NPI | 1063467710 |
---|---|
Provider Name | James J Lee |
First Address | Greensboro, NC 27408 |
Second Address | Greensboro, NC 27408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51467 | BCBS (01) | NC |
8951467 | (05) | NC |
C85246 | (02) |