Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 0101267057 | VA |
NPI | 1245752526 |
---|---|
Provider Name | Seung Duk Lee |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23298-5049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2017 |
Last Update Date | 26/09/2019 |